• The Korean journal of internal medicine
• /
• v.33 no.6
• /
• pp.1143-1149
• /
• 2018

Background/Aims: The purpose of this study was to compare maternal and neonatal outcomes in Korean women with type 2 diabetes and nondiabetic controls. Methods: We performed a retrospective survey of 200 pregnancies in women with type 2 diabetes (n = 100) and nondiabetic controls (n = 100) who delivered from 2003 to 2010 at Cheil General Hospital & Women's Healthcare Center, Korea. We compared maternal characteristics as well as maternal and neonatal outcomes between groups matched by age, pre-pregnancy weight, body mass index, parity, and gestational age at delivery. Results: The number of infants that were small for gestational age and the rate of major congenital malformations were not significantly different. However, women with type 2 diabetes showed a slightly higher risk for primary caesarean section (35.0% vs. 18.0%, p = 0.006) as well as pre-eclampsia (10.0% vs. 2.0%, p = 0.017), infections during pregnancy (26.0% vs. 2.0%, p < 0.001), neonatal weight ($3,370{\pm}552.0$ vs. $3,196{\pm}543.3$, p = 0.025), large for gestational age (22.0% vs. 9.0%, p = 0.011), and macrosomia (15.0% vs. 5.0%, p = 0.018) compared to nondiabetic controls. Conclusions: Maternal and neonatal outcomes for women with type 2 diabetes were worse than those for nondiabetic controls. Diabetic women have a higher risk for primary caesarean section, pre-eclampsia, infections during pregnancy, large neonatal birth weight, large for gestational age, and macrosomia.

• Clinical and Experimental Pediatrics
• /
• v.50 no.8
• /
• pp.732-739
• /
• 2007

Purpose : A universal standard of the birth weight for gestational age cannot be made since birth weight distribution varies with races, nations and eras. This report aims to establish the birth weight for gestational age patterns by sex, plurality, and parity, specific for Korean live births. Methods : The national birth certificate data of all live births in Korea from January 2000 to December 2004 were used: for live births with gestational age 24 weeks to 42 weeks (n=2,585,5160), mean birth weight, standard deviation and 10th, 25th, 75th and 90th percentile values were obtained for each gestational age group by one week increment. To establish final standard values of Korean birth weight distribution by gestational age, the finite mixture model to eliminated erroneous birth weights was used for respective gestational age. Same as above method the birth weight for gestational age standard by sex, plurality, and parity were completed. Results : The male newborns are more heavier than female during the entire gestational age. The singletons are more heavier than twin during the entire gestational age. The para 2 are more heavier than the para 1 during the entire gestational age. Korean standard was more heavier in 10th and 50th percentile than Lubchenco's standard. Alexander's standard was more heavier in 50th and 90th percentile than Korean standard. Conclusion : These birth weight for gestational age patterns by sex, plurality, and parity are similar to the other standards. I hope that for Korean infants, this curve will help clinicians in defining and managing the large for gestational age infants and also for infants with intrauterine growth retardation.

• Applied Microscopy
• /
• v.23 no.1
• /
• pp.56-76
• /
• 1993

To investigate the histogenesis of tracheal epithelium in Sprague-Dawley strain rat, the author has used the fetal rats at the 16th, 18th, 20th and 22nd prenatal day and neonatal rats at the 1st and 7th day as well as rats at age of 5, 10 and 15 weeks after birth as experimental animals. Specimens were double stained with uranyl acetate and lead citrate for electron microscopic study. The results obtained were as follows; 1. At the 16th day of gestational age, ciliated cells were found in tracheal epithelium and light and dark ciliated cells possessing numerous mitochondria and smooth endoplasmic reticulum in the cytoplasm at the 22nd day of gestational age of the rat are observed. 2. At the 16th day of gestataional age, basal cells lying upon the basement membrane and having large numbers of glycogen particles in the cytoplasm, were found and at the 22nd day of gestational age, basal cells possessing numerous polysomes in the cytoplasm were observed. 3. At the 20th gestational age of the rat, microvillous cells possessing many rough endoplasmic reticulum and mitochondria as well as microvilli protruding into the lumen were found in tracheal epithelium. 4. At the 5th week after birth brush cell having profound filamentous strands and many pinocytic vesicles in the cytoplasm, was visible in the tracheal epithelium. 5. At the 15th week after birth large proportions of tracheal epithelium were lined with ciliated cells. Cosequently it is suggested that pseudostratified ciliated columnar epithelium was differentiated at the 16th day of gestational age, in addition cytoplasmic organelles of the microvillous and basal cells were matured at the 20th and 22nd gestational age, respectively and most of the part of the tracheal epithelium was lined with ciliated cells at the 15th week after birth.

• Clinical and Experimental Pediatrics
• /
• v.48 no.11
• /
• pp.1179-1186
• /
• 2005

Purpose : A universal standard of the birth weight for gestational age cannot be made since girth weight distribution varies with race and other sociodemographic factors. This report aims to establish the birth weight distribution curve by gestational age, specific for Korean live births. Methods : We used the national birth certificate data of all live births in Korea from January 2001 to December 2003; for live births with gestational ages 24 weeks to 44 weeks(n=1,509,763), we obtained mean birth weigh, standard deviation and 10th, 25th, 50th, 75th and 90th percentile values for each gestational age group by one week increment. Then, we investigated the birth weight distribution of each gestational age group by the normal Gaussian model. To establish final standard values of Korean birth weight distribution by gestational age, we used the finite mixture model to eliminate erroneous birth slights for respective gestational ages. Results : For gestational ages 28 weeks 32 weeks, birth weight distribution showed a biologically implausible skewed tail or bimodal distribution. Following correction of the erroneous distribution by using the finite mixture model, the constructed curve of birth weight distribution was compared to those of other studies. The Korean birth weight percentile values were generally lower than those for Norwegians and North Americans, particularly after 37 weeks of gestation. The Korean curve was similar to that of Lubchenco both 50th and 90th percentiles, but generally the Korean curve had higher 10th percentile values. Conclusion : This birth weight distribution curve by gestational age is based on the most recent and the national population data compared to previous studies in Korea. We hope that for Korean infants, this curve will help clinicians in defining and managing the large for gestational age infants and also for infants with intrauterine growth retardation.

• Clinical and Experimental Pediatrics
• /
• v.50 no.6
• /
• pp.543-548
• /
• 2007

Purpose : The anthropometric data of newborns published by Lubchenco et al in the 1960's have been most commonly used in Korea as a standard of newborn growth. We hypothesized that Lubchenco's data have limitations for Korean premature infants born in the 2000's. We analyzed and compared the data of birth weight, length, and head circumference. Methods : The medical records of 1,159 premature infants of 26 to 35 weeks of gestational age born at Il-Sin Christian Hospital of Busan from January 2,000 to August 2,006 were reviewed. The anthropometric data from total 1,010 premature infants were analyzed after excluding the data from infants whose gestational age were estimated by other than ultrasonogram, and infants with major congenital anomalies or chromosomal anomaly, born from foreign parent, and extreme outliers. Results : In the birth weights by gestational age, our 90 percentile values were lower than Lubchenco's 90 percentile values for all gestational age studied, particularly for less than 30 weeks the 90 percentile curve was drawn at the area as that of Lubchenco' 75 percentile. And our 10 percentile values were higher than Lubchenco's 10 percentile values for all gestational age studied. In the birth length and head circumference by gestational age, our 90 percentile values were lower than Lubchenco's 90 percentile values for all gestational age studied, and the 90 percentile curve was drawn at the area as that of Lubchenco's 75 percentile. And our 10 percentile values were higher than Lubchenco's 10 percentile values for all gestational age studied. Conclusion : It is unreasonable to apply Lubchenco's data published before 4th decades to present Korean premature infants and have a risk to underestimate intrauterine growth retardation or small for gestational age and large for gestational age. Considering for the possibility of increasing the mortality and morbidity of premature infants due to delayed diagnosis and treatment by these underestimating, our anthropometric data of premature infant is expected to contribute to lower the mortality and morbidity of premature infants.

• Journal of Genetic Medicine
• /
• v.8 no.1
• /
• pp.71-75
• /
• 2011

A male infant was diagnosed with obstetric brachial plexus injury, congenital muscular torticollis and cleft palate 17 days after birth. His mother presented with gestational diabetes and premature rupture of membranes. Although it is possible that these three disorders arose independently, it is very likely that all three have the same etiologic cause, and we propose that a possible mechanism for this concurrence is related to maternal gestational diabetes. Maternal hyperglycemia mostly affects fetal structures deriving from the neural crest, including the palatine bone, and may have caused the cleft palate observed in this case. Gestational diabetes is also associated with increased frequency of large for gestational age infants and, by extension, with increased risk of birth injuries such as obstetric brachial plexus injury or congenital muscular torticollis associated with large for gestational age infants. Since the children of mothers with gestational diabetes are at increased risk for congenital defects such as cleft palate as well as being large for gestational age, precautions indicated for each respective disorder must be taken during prenatal testing and during birth. However, further studies of more cases are required to evaluate whether the concurrence of obstetric brachial plexus injury, congenital muscular torticollis and cleft palate in this case are complications specifically associated with gestational diabetes or just a simple coincidence.

• Clinical and Experimental Pediatrics
• /
• v.58 no.3
• /
• pp.77-83
• /
• 2015

Relative to a fetus of the same gestational age, very low birth weight (VLBW) infants are more likely to be underfed and to undergo growth restriction during their early hospital stay. The current trend towards "early and aggressive" nutritional strategies in VLBW infants aims to overcome the early nutritional deficiency and thereby boost postnatal catch-up growth, simultaneously improving long-term neurodevelopmental outcomes. Although the minimum starting amino acid (AA) dose to prevent negative nitrogen balance is well established, the upper limit and the rate of increase of early AA doses are controversial. Most randomized controlled trials show that early and high-dose (target, 3.5 to 4.9 g/kg/day) AA regimens, with or without high nonprotein calories, do not improve long-term growth and neurodevelopment. High-dose AA supplementation may lead to early metabolic disturbances and excessive or disproportionate plasma AA levels, particularly in infants of very low gestational age. Further large studies are needed to clarify the optimal strategy for early administration of parenteral AA doses in VLBW infants.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.23 no.4
• /
• pp.366-376
• /
• 2020

Purpose: To assess the association between birth weight and the development of functional gastrointestinal disorders (FGIDs) in the first year of life. Methods: This is a secondary analysis of a prospective cohort multicenter study including neonates, consecutively enrolled at birth, and followed up for one year. At birth all infants were classified by birth weight as extremely low (ELBW), very low, or low when <1,000, <1,500, and <2,500 g, respectively, and by birth weight for gestational age as appropriate (AGA, weight in the 10-90th percentile), small (SGA, weight <10th percentile), and large (LGA, weight >90th percentile) for gestational age. FGIDs were classified according to the Rome III criteria and assessed at 1, 3, 6, and 12 months of life. Results: Among 1,152 newborns enrolled, 934 (81.1%) completed the study: 302 (32.3%) were preterm, 35 (3.7%) were ELBW, 104 (11.1%) were SGA, 782 (83.7%) were AGA, and 48 (5.1%) were LGA infants. Overall, throughout the first year of life, 718 (76.9%) reported at least one FGID. The proportion of infants presenting with at least one FGID was significantly higher in ELBW (97%) compared to LBW (74%) (p=0.01) and in LGA (85.4%) and SGA (85.6%) compared to AGA (75.2%) (p=0.0001). On multivariate analysis, SGA was significantly associated with infantile colic. Conclusion: We observed an increased risk of FGIDs in ELBW, SGA, and LGA neonates. Our results suggest that prenatal factors determining birth weight may influence the development of FGIDs in infants. Understanding the role of all potential risk factors may provide new insights and targeted approaches for FGIDs.

• Clinical and Experimental Pediatrics
• /
• v.46 no.5
• /
• pp.447-453
• /
• 2003

Purpose : This study was performed to compare complications and perinatal factors according to the birth weight groups in the infants of diabetic mothers(IDM). Methods : Three hundred and one singleton diabetic mothers and their babies of more than 30 weeks' gestational age admitted in the department of Pediatrics, Chonnam University Hospital from January 1996 to March 2002 were enrolled. Complications and perinatal factors were compared between large for gestational age(LGA) and appropriated for gestational age(AGA) infants. Results : Hypomagnesemia was observed in 37.5%, jaundice in 21.3%, hypoglycemia in 11.1%, hypocalcemia in 7.0%, and birth injury in 19.6%. Congenital anomaly was noted in 24.9% with cardiovascular anomaly most commonly. In the LGA group, the frequencies of jaundice, hypoglycemia, tachypnea, and birth injuries were higher, and the interventricular septum was thicker than the AGA group. In the LGA group, Cesarean section rate, maternal height, weight before pregnancy, weight gain during pregnancy, and the incidence of unawareness of gestational DM were significant compared with the AGA group. Conclusion : In the LGA group, the frequencies of jaundice, hypoglycemia, tachypnea, and birth injuries were higher, and the interventricular septum was thicker than the AGA group. In the LGA group, maternal height, weight before pregnancy and weight gain during pregnancy were larger, and the incidence of unawareness of gestational DM was higher compared with the AGA group. These results suggest that careful examination and management are needed to detect the high risk, pregnant DM mothers with possible LGA babies.

• Korea journal of population studies
• /
• v.35 no.1
• /
• pp.131-149
• /
• 2012

This study examined the effect of parental socioeconomic position on the association between birth outcomes and infant mortality in early and late 2000's. Linked Birth and Infant Death data sets from 2001 to 2003 (T1) and from 2006 to 2008 (T2), provided by the Korea National Statistical Office, were used for analysis. Birth outcomes were categorized into four groups: normal term, small-for-gestational age (SGA), large-for-gestational age (LGA) and intrauterine growth retardation (IUGR). Infant death was defined as the death of a live-born child under one year of age; indicators of parental socioeconomic position were limited to parental education and occupation. The results showed that T2 infant mortality hazard ratios of SGA and IUGR have increased compared to T1. Particularly, preterm and low birth weight babies with shorter gestational age and lighter birth weight than T1 have elevated in T2, possibly indicating that population quality might be continuously aggravated. Moreover, the effect of maternal age on infant mortality has disappeared, rather that of parents' socioeconomic position has increased during the periods, which entailed growing disparities in infant mortality by their social class. Further studies should be therefore done to estimate the effect of parental socioeconomic position on the relationship between birth outcomes and infant mortality in the near future.