• Neonatal Medicine
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• 제15권1호
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• pp.38-43
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• 2008

목 적 : 태아 시기의 성장이 출생 이후 성인기에 이르기까지 대사 질환 및 심혈관 질환, 제2형 당뇨병 등의 발현에 영향을 미친다는 보고들이 있어왔다. 이에, 정상 체중 만삭아의 제대혈 내 APN 과 IGF-I 농도와 태아 성장 간의 관계에 대해서 알아보고자 하였다. 방 법 : 2003년 10월부터 2005년 3월 사이에 이대목동병원에서 출생한 정상 체중 만삭아 72명을 대상으로 하였다. 대상아들의 제대혈 내 APN과 IGF-I 농도를 ELISA 방법을 이용하여 측정하였고 측정치와 출생체중, 신장, 머리둘레, 성별, ponderal index, 태반 무게, 태아-태반 무게 비, 산모의 임신 중 체중 증가, 산모의 임신 전 BMI와의 관계를 분석하였다. 결 과: 제대혈 평균 APN 농도는 29.2${\pm}$10.46 $\mu$g/mL 였으며, 제대혈 APN 농도와 체중의 관계는 체중이 증가할수록 APN 농도가 증가하다가 일정 체중에 도달한 이후에는 APN이 감소하는 종모양의 관계를 보였다. 제대혈 APN 농도는 여아에서 남아 보다 높았으며(P=0.001), 제대혈 APN 농도와 산모의 BMI는 유의한 음의 상관관계를 보였다(r=-0.301, P=0.027). 평균제대혈 IGF-I 농도는 51.26${\pm}$21.54 ng/mL 였다. 제대혈 IGF-I 농도는 출생체중과 양의 상관관계를 보였다(r=0.312, P=0.009). 결 론: 건강한 만삭아에서 제대혈 APN 농도는 출생 체중에 따라 증가하다가 일정 체중에서부터 감소하는 패턴의 종모양의 관계를 보였다. IGF-I 은 태아 성장, 특히 출생체중과 밀접한 관계가 있었다.

• Journal of Nutrition and Health
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• 제35권1호
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• pp.69-77
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• 2002

The purpose of this study was to determine the probability of overweight throughout childhood in relation to the presence of overweight at birch or in early childhood, and presence of overweight in children's parents. Weight and height measures were collected at birth and at ages of 7, 10, 12 years from 655 6th grade primary schoolchildren. Childhood overweight was defined as a body mass index at or above the 85th percentile for age and sex, and overweight in children's parents as a body mass index at or above 27. The prevalence of overweight increased with age of the children. Overweight at birth was not associated with overweight at 12 years of ages. However, overweight at 12 years old was already related to overweight at 7 years old. In comparison to non-overweight peers, overweight children at ages 7(OR = 7.64, 95% CI = 4.32-13.51) and 10 years(OR = 19.69, 95% CI = 11.42-33.94) had a higher rick of becoming overweight at 12 years of age. Among children who was overweight at age 7years, 60.7% remained overweight 5 years later, Yearly increment in BMI of overweight children was larger than that of non-obese children (1.15-1.65kg/m$^2$vs 0.50-0.71kg/m$^2$. As compared with the lower case in mealy increment of BMI, the probability of being overweight at age of 12 years was greater in higher case. BMI values at age 7years were positively correlated with BMI values at age of 10 and 127ear,i, and with annual increments in BMI. But those relationships with birth weight were not observed. Children were at greater risk for overweight if at least ogle parent was overweight. The odds ratio for child overweight associated with maternal overweight was 2.41(95% CI = 1,13-5.IS), and those associated with paternal overweight 1.70(95% CI = 0.92-3.17). And parents' BMIs were positively correlated with children's BMI values and yearly BMI increment. In conclusion, overweight at early childhood and annual inclement in BMI can be important in predicting the prevalence of overweight and the risk that overweight will remain after 7 years of age. The risk of being overweight throughout the childhood increases by the parents'overweight.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제20권3호
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• pp.186-193
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• 2017

Purpose: Obesity is one of the most common health problems among children and its prevalence has increased in recent decades. Socioeconomic status (SES) is a well-known risk factor for childhood obesity although the associations were different across countries. Previous studies in other countries have reported a positive association between childhood obesity and SES in developing countries, and inverse correlation has been reported in developed countries. For this reason, we wanted to investigate the relationship between SES and obesity in Korean children. Methods: Data were acquired 3,095 boys and girls who participated in the fifth Korea National Health and Nutrition Examination Survey, which was conducted from 2010 to 2012. Body mass index was calculated from measured anthropometric data using the 2007 Korean National Growth Charts. Results: Upon univariate analysis, we did not find any statistically significant differences in the parental employment status, monthly family income between children with and without obesity. Multiple logistic regression analysis showed childhood obesity was positively associated with maternal overweight (OR, 1.889; 95% CI, 1.079-3.309), maternal obesity (OR, 3.409; 95% CI, 2.228-5.215) and paternal obesity (OR, 2.135; 95% CI, 1.257-3.627). Conclusion: The present study showed that socioeconomic status might not an important risk factor for obesity in Korean children. These results warrant further studies to clarify the association between SES and obesity in Korean children.

• Journal of Korean Medical Science
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• 제33권48호
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• pp.311.1-311.10
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• 2018

Background: In postmenopausal women, there is rapid bone loss due to estrogen depletion. In women, reproductive factors such as age at menarche, breastfeeding, and parity are considered risk factors of osteoporosis. Many reports suggest that obesity is associated with a reduced risk of osteoporosis. This nationwide, population-based study aims to identify the association between maternal age and osteoporosis risk in postmenopausal women of different obesity classifications. Methods: We assessed data from the Korean National Health and Nutrition Examination Survey 2010-2012. The study included 1,328 postmenopausal women, after excluding women with missing data for reproductive history among 4,546 postmenopausal women in the survey. Multivariate regression was used to identify the association between childbirth age and postmenopausal bone mineral density after adjustments for confounding factors. Results: The prevalence of postmenopausal osteoporosis was 35.24% (n = 468). After dividing the subjects into obese and non-obese groups based on body mass index (BMI) and waist circumference, there were significant differences between non-osteoporosis and osteoporosis groups with regard to age at first childbirth, age at last childbirth, and parity in the BMI-based general obesity group. The prevalence of osteoporosis was highest in women older than 35 years old at last childbirth. The prevalence of osteoporosis was also greater in women with parity ${\geq}4$ compared to those with lower parity levels. Conclusion: Postmenopausal women of older age at last childbirth and higher parity were at increased risk of osteoporosis in the BMI-based non-general obesity group.

• Perinatology
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• 제29권4호
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• pp.189-194
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• 2018

Congenital neuroblastoma is a rare disease. Placental metastasis is extremely rare and poor prognosis has been reported in neonates. Mirror syndrome could occur in mother with placental metastasis with possibilities of hypertension and edema. We report a case of detection of left suprarenal mass in fetus at $31^{+5}weeks^{\prime}$ gestation. Mother presented with palpitation, edema, headache, and hypertension. Maternal 24 hours urine vanillylmandelic acid (VMA) and normetanephrine (NME) level at 34 weeks' gestation were elevated. Consequently, emergent cesarean section was done. Based on abdominal ultrasonography and whole body magnetic resonance imaging, left adrenal tumor with liver metastasis was suspected. Neuroblastoma was confirmed by liver and placenta biopsy. Chemotherapy was started with Pediatric Oncology Group 9243 at day 7 and changed into Children's Oncology Group 3961 due to cholestasis and poor response during 2nd cycle. Plasma exchange was done for aggravated direct hyperbilirubinemia. The baby expired at 73 days due to multi-organ failure. Maternal symptoms were completely resolved in 2 weeks after delivery along with normalization of the elevated level of VMA and NME. We report a first case of mirror syndrome in Korean mother and fetus resulting from metastatic congenital neuroblastoma to placenta.

• Child Health Nursing Research
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• 제26권2호
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• pp.277-285
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• 2020

Purpose: This study aimed to identify factors-both infant-related and maternal-associated with pressure to eat as a feeding practice among mothers with infants. Methods: This study used a cross-sectional design and included 163 mothers of infants aged 2~12 months. Of the 180 self-reported questionnaires that were distributed, 163 (91%) were included in the data analysis. Multiple regression analysis was used to identify the factors associated with pressure to eat as a feeding practice among the mothers. Results: Infant's temperament (β=-.17, p=.035), mother's body mass index (β=-.16, p=.048), and concern about the infant being underweight (β=.30, p=.001) were associated with pressure to eat as a feeding practice among mothers. The explanatory power of these variables in the predictive model was 19.2%. Conclusion: Educational programs should be developed for improving mother's awareness of cues from infants with difficult temperament. In addition, educational interventions regarding the correct evaluation of infant's weight are needed to relieve mother's concern about their infant's being underweight. These interventions might be helpful to reduce the prevalence of pressure to eat as a feeding practice among mothers with infants.

• Advances in pediatric surgery
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• 제19권2호
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• pp.81-89
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• 2013

The purposes of this study was to describe the clinical correlation of mass size and gestational age, prognostic factors in sacrococcygeal teratoma (SCT) at a tertiary pediatric surgery, University of Ulsan College of Medicine and Asan Medical Center (AMC), Seoul, Korea. Fifty five patients admitted to the AMC with a SCT between May 1989 and April 2013 were included in this retrospective review. Mean follow up was 861 days. Mean maternal age at delivery was $30{\pm}2.7$ year, mean gestational age (GA) was $36.9{\pm}3.6$ wks, and preterm delivery was 21.8%. Birth body weight was $3182{\pm}644$ g and male vs. female ratio was 1:2.05. We can't find significant difference between Caesarean section and maternal age at delivery (p =0.817). But, caesarean section was favored by gestational age (p = 0.002), larger tumor size (p =0.029) or higher tumor weight fraction rate to birth body weight (p =0.024). Type I was 13, II 21, III 17, and IV 3 according to Altman et al. classification. The tumor component was predominantly cystic(> 50%) in 73.1 %. And the majority histological classification of tumors were mature teratoma (70.3%). The motality rate was 5.5%. Three patients expired because of postpartum bleeding, post-op bleeding related complication such as DIC. SCT recurred in four patients. The interval between first and second operation was $206.2{\pm}111.0$ d (range 53~325 d). In two patients, serum AFP levels were elevated at a regular checkup without any symptom, and subsequent imaging studies revealed SCT. The most common cause of death was bleeding and bleeding related complication. So Caesarean section and active peripartum and perioperative management will be needed for huge solid SCT. In the case of Yolk sac tumor or huge immature teratoma, possibility of recurrence have to be always considered, so follow up by serial AFP and MRI is important for SCT management.

• Nutrition Research and Practice
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• 제9권4호
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• pp.433-438
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• 2015

BACKGROUND/OBJECTIVES: Breast milk is the best available food for optimum growth and development of infants and the breastfeeding rate is increasing in Korea. The purpose of this study is to measure the concentrations of macronutrients and to evaluate their changes according to lactation period in breast milk from lactating Korean women. SUBJECTS/METHODS: Milk samples were obtained from 2,632 healthy lactating women (mean age; $32.0{\pm}3.3years$), where the lactating period was up to a period of 8 months, who also volunteered to participate in the Human Milk Macronutrient Analysis Research. Lactose, protein, fat and water content in the breast milk samples were analyzed with infrared spectrometry using MilkoScan FT-2. RESULTS: The mean macronutrient composition per 100 mL of mature breast milk was 7.1 g for lactose, 1.4 g for protein and 3.0 g for fat, and energy content was 61.1 kcal. The protein concentration was significantly lower in milk samples at 1-2 weeks (2.0 g/dL) to 2-3 months (1.4 g/dL) than those at 0-1 week (2.2 g/dL), but it was similar among samples from 3-4 months to 7-8 months (1.3 g/dL). Mean lipid levels varied among different lactational period groups (2.7-3.2 g/dL), but presented no significant difference. Lactose concentration in the milk samples did not differ with lactation period. Maternal body mass index was positively related to protein and lipid breast milk contents, but was negatively related to lactose content. General linear models examining the associations between maternal variables and milk macronutrient content revealed that lactation period had a major impact on protein and lipid, but not on lactose content in breast milk. CONCLUSIONS: These results warrant future studies to explore factors that may be associated with changes in macronutrient content in human milk.

• Asian-Australasian Journal of Animal Sciences
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• 제26권10호
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• pp.1379-1387
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• 2013

In a majority of mammals, male infants have heavier body mass and grow faster than female infants. Accordingly, male offspring nursing requires a much greater maternal energy contribution to lactation. It is possible that the maternal-fetal immunoendocrine dialog plays an important role in female preparation for lactation during pregnancy. Immune system genes are an integral part of gene regulatory networks in lactation and tumor necrosis factor alpha ($TNF{\alpha}$) is a proinflammatory cytokine that also plays an important role in normal mammary gland development. The aim of this study was to evaluate the influence of the sex of calf and/or the -824A/G polymorphism in the promoter region of $TNF{\alpha}$ gene on milk performance traits in Black Pied cattle over the course of lactation. We also studied the allele frequency differences of -824A/G variants across several cattle breeds, which were bred in different climatic conditions. The G allele frequency decreased gradually over the course of lactation events in the Black Pied dairy cattle because of a higher culling rate of cows with the G/G genotype (p<0.001). In contrast to the genotypes A/A and A/G, cows with G/G genotype showed significant variability of milk and milk fat yield subject to sex of delivered calf. Milk yield and milk fat yield were significantly higher in the case of birth of a bull calf than with a heifer calf (p<0.03). The G allele frequency varies from 48% to 58% in Grey Ukrainian and Black Pied cattle to 77% in aboriginal Yakut cattle. Our results suggest that the $TNF{\alpha}$-824A/G gene polymorphism may have an influence on the reproductive efforts of cows over the course of lactation events depending on the sex of progeny. Allocation of resources according to sex of the calf allows optimizing the energy cost of lactation. This may be a probable reason for high G allele frequency in Yakut cattle breeding in extreme environmental conditions. Similarly, the dramatic fall in milk production after birth of a heifer calf increases the probability of culling for the cows with the G/G genotype in animal husbandry.

• 융합신호처리학회논문지
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• 제19권3호
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• pp.118-124
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• 2018

임신 중 비만은 다양한 합병증을 증가시키고, 출산 시 여러 가지 문제를 유발한다. 그러나 이러한 비만인 산모가 임신중 부정적인 영향을 받는 요인들에 대한 종합적인 분석은 부족한 실정이다. 따라서 본 연구에서는 산모의 신체질량지수를 이용하여 비만 정도에 따른 고위험 질환의 일곱 가지 발생요인들의 영향을 분석하고자 한다. 임신 중 정기검진을 받은 산모 279명을 대상으로 산모의 비만정도를 신체질량지수로 분류하고 산모의 신체질량지수와 임신성 고혈압, 임신성 당뇨, 갑상선자극호르몬과의 유의성을 판단하기 위해 차이분석을 실행하였다. 또한 산모의 나이, 신장기능, 총콜레스테롤, 신생아몸무게와 어떠한 연관성이 있는지 파악하기 위해 회귀분석을 실행하였다. 그 결과, 산모의 비만정도가 높을수록 고혈압 산모, 당뇨산모, 이상갑상선수치를 가진 산모의 비율이 높게 나타났으며 산모의 신체질량지수와 나이, 총콜레스테롤, 신생아몸무게와는 양의 상관관계, 신장기능수치와는 음의 상관관계가 있었다.