• 대한한방부인과학회지
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• 제27권3호
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• pp.94-103
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• 2014

Objectives: The aim of this study is to identify effects and safety of Korean traditional medicine, especially including Pinelliae Rhizoma, for hyperemesis gravidarum, and to suggest appropriate dosage and treatment duration of Pinelliae Rhizoma. Methods: The study was performed based on the medical records of 19 hyperemesis gravidarum patients treated with Korean traditional medicine including Pinelliae Rhizoma. Change of symptoms, continuance of pregnancy, malformation of infants, and delivery outcomes were analysed. Results: The symptoms of hyperemesis gravidarum were improved in 13 patients. With regards to pregnancy outcome, normal fullterm delivery was 16 case, preterm delivery was 1 case and abortion was 2 case, Infants malformation was not found in any case. The average daily dosage of Pinelliae Rhizoma was 6.53 g/day, and the average treatment duration of Pinelliae Rhizoma was 11.53 (day). Conclusions: In this study, using Korean traditional medicine including Pinelliae Rhizoma for hyperemesis gravidarum patients is considered safe if patients are treated with proper clinical dosage and duration of medication. More cases and studies in the future will be required for the appropriate use of Pinelliae Rhizoma for hyperemesis gravidarum patients.

• Neonatal Medicine
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• 제28권3호
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• pp.108-115
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• 2021

Purpose: Magnetic resonance imaging (MRI) is a useful tool for evaluating brain injury and maturation in preterm infants and often requires sedation to acquire images of sufficient quality. Infant sedation is often associated with adverse events, despite extreme precautions. In this study, the swaddling technique was investigated as an alternative non-pharmacological strategy to obtain brain MRIs of sufficient quality. Methods: We applied the feed and swaddle technique during routine brain MRI as a quality improvement project and compared its morbidity with that of sedation in a historic age-matched group. Seventy-nine very low birth weight infants in the neonatal intensive care unit of Ajou University Hospital (Suwon, Korea) were enrolled. Thirty-two (40.5%) infants were in the feed and swaddling group, and 47 (59.5%) were in the sedation group. Results: The morbidity associated with the cardiopulmonary system (swaddling group vs. sedation group: 53.13% [n=17] vs. 63.83% [n=30], P=0.723) and central nervous system (40.63% [n=13] vs. 29.79% [n=14], P=0.217) were not significantly different between groups. The MRI failure rate was not significantly different (swaddling group vs. sedation group: 12.5% [n=4] vs. 4.3% [n=2], P=0.174). The MRI scanning time was longer in the swaddling group than in the sedation group (76.5±20.3 minutes vs. 61.5±13.6 minutes, P=0.001). Cardiopulmonary adverse events were significantly less common in the swaddling group than in the sedation group (3.13% [n=1] vs. 34.04% [n=16], P=0.002). Conclusion: The success rate of MRI was comparable between the swaddling technique and sedation. Furthermore, despite the drawback of prolonged scan time, cardiopulmonary adverse events are fewer with swaddling than with sedative agents. Therefore, swaddling can be an alternative to sedation or anesthesia when performing neonatal MRI scans.

• Clinical and Experimental Pediatrics
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• 제64권1호
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• pp.37-43
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• 2021

Background: Animal studies have shown that a leukocyte influx precedes the development of bronchopulmonary dysplasia (BPD) in premature sheep. The CXC chemokine receptor 2 (CXCR2) pathway has been implicated in the pathogenesis of BPD because of the predominance of CXCR2 ligands in tracheal aspirates of preterm infants who later developed BPD. Purpose: To test the effect of CXCR2 antagonist on postnatal systemic and pulmonary inflammation and alveolarization in a newborn Sprague-Dawley rat model of BPD. Methods: Lipopolysaccharide (LPS) was injected intraperitoneally (i.p.) into the newborn rats on postnatal day 1 (P1), P3, and P5 to induce systemic inflammation and inhibit alveolarization. In the same time with LPS administration, CXCR2 antagonist (SB-265610) or vehicle was injected i.p. to investigate whether CXCR2 antagonist can alleviate the detrimental effect of LPS on alveolarization by attenuating inflammation. On P7 and P14, bronchoalveolar lavage fluid (BALF) and peripheral blood (PB) were collected from the pups. To assess alveolarization, mean cord length and alveolar surface area were measured on 4 random nonoverlapping fields per animal in 2 distal lung sections at ×100 magnification. Results: Early postnatal LPS administration significantly increased neutrophil counts in BALF and PB and inhibited alveolarization, which was indicated by a greater mean cord length and lesser alveolar surface area. CXCR2 antagonist significantly attenuated the increase of neutrophil counts in BALF and PB and restored alveolarization as indicated by a decreased mean cord length and increased alveolar surface area in rat pups exposed to early postnatal systemic LPS. Conclusion: CXCR2 antagonist preserved alveolarization by alleviating pulmonary and systemic inflammation induced by early postnatal systemic LPS administration. These results suggest that CXCR2 antagonist can be considered a potential therapeutic agent for BPD that results from disrupted alveolarization induced by inflammation.

• Neonatal Medicine
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• 제28권3호
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• pp.124-132
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• 2021

Purpose: Neonatal near miss (NNM) allows for the detection of risk factors associated with serious newborn complications and death, the prevention of which could reduce neonatal mortality. This study was conducted with the objective of identifying predictors for NNM in a tertiary hospital in Bangalore city. Methods: This was an unmatched case-control study involving 120 NNM cases and 120 controls. NNM was determined using Pileggi-Castro's pragmatic and management criteria. Data was collected from in-patient hospital records and interviews of postpartum mothers. Multiple logistic regression of exposure variables was performed to calculate adjusted odds ratio (AOR) with 95% confidence interval (CI). Results: Significant predictors were maternal age ≥30 years (AOR, 5.32; 95% CI, 1.12 to 9.29; P=0.041), inadequate antenatal care (ANC) (AOR, 8.35; 95% CI, 1.98 to 51.12; P=0.032), <3 ultrasound scans during pregnancy (AOR, 12.5; 95% CI, 1.60 to 97.27; P=0.016), maternal anaemia (AOR, 18.96; 95% CI, 3.10 to 116.02; P=0.001), and any one obstetric complication (hypertensive disorder in pregnancy, diabetes in pregnancy, preterm premature rupture of membranes, prolonged labour, obstructed labour, malpresentation) (AOR, 4.34; 95% CI, 1.26 to 14.95; P=0.02). Conclusion: The predictors of NNM identified has important implications for public health policy and practice whose modifications can improve NNM. These include expanding essential ANC package to include ultrasound scans, ensuring World Health Organization recommendations of eight ANC visits, capacity building at all levels of health care to strengthen routine ANC and obstetric care for effective screening, referral and management of obstetric complications.

• Clinical and Experimental Pediatrics
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• 제64권5호
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• pp.239-246
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• 2021

Background: The consequences of severe acute respiratory syndrome corona virus 2 on mother and fetus remain unknown due to a lack of robust evidence from prospective studies. Purpose: This study evaluated the effect of coronavirus disease 2019 (COVID-19) on neonatal outcomes and the scope of vertical transmission. Methods: This ambispective observational study enrolled pregnant women with COVID-19 in North India from April 1 to August 31, 2020 to evaluate neonatal outcomes and the risk of vertical transmission. Results: A total of 44 neonates born to 41 COVID-19-positive mothers were evaluated. Among them, 28 patients (68.3%) (2 sets of twins) were delivered within 7 days of testing positive for COVID-19, 23 patients (56%) (2 sets of twins) were delivered by cesarean section; 13 newborns (29.5%) had low birth weight; 7 (15.9%) were preterm; and 6 (13.6%) required neonatal intensive care unit admission, reflecting an increased incidence of cesarean delivery and low birth weight but zero neonatal mortality. Samples of cord blood, placental membrane, vaginal fluid, amniotic fluid, peritoneal fluid (in case of cesarean section), and breast milk for COVID-19 reverse transcription-polymerase chain reaction tested negative in 22 prospective delivery cases. Nasopharyngeal swabs of 2 newborns tested positive for COVID-19: one at 24 hours and the other on day 4 of life. In the former case, biological samples were not collected as the mother was asymptomatic and her COVID-19 report was available postdelivery; hence, the source of infection remained inconclusive. In the latter case, all samples tested negative, ruling out the possibility of vertical transmission. All neonates remained asymptomatic on follow-up. Conclusion: COVID-19 does not have direct adverse effects on the fetus per se. The possibility of vertical transmission is almost negligible, although results from larger trials are required to confirm our findings.

• Journal of Preventive Medicine and Public Health
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• 제54권5호
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• pp.309-316
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• 2021

Objectives: This study examined stunting at birth and its associations with physical factors of parents and children in Indonesia. Methods: This study analyzed secondary data from the national cross-sectional Indonesian Basic Health Survey 2018, conducted across 34 provinces and 514 districts/cities. Birth length data were available for 756 newborns. Univariable, bivariable, and multivariable logistic regression analyses were performed to determine associations between the physical factors of parents and children and stunting at birth. Results: In total, 10.2% of children aged 0 months were stunted at birth (10.7% of males and 9.5% of females). Stunting at birth was associated with the mother's age at first pregnancy, parity, parents' heights, parents' ages, and gestational age. Children from mothers with short statures (height <145.0 cm) and fathers with short statures (height <161.9 cm) had an almost 6 times higher likelihood of being stunted at birth (adjusted odds ratio, 5.93; 95% confidence interval, 5.53 to 6.36). A higher maternal age at first pregnancy had a protective effect against stunting. However, other variables (firstborn child, preterm birth, and both parents' ages being <20 or >35 years) corresponded to a 2-fold higher likelihood of stunting at birth compared to the reference. Conclusions: These findings provide evidence that interventions to reduce stunting aimed at pregnant females should also consider the parents' stature, age, and parity, particularly if it is the first pregnancy and if the parents are short in stature or young. Robust programs to support pregnant females and monitor children's heights from birth will help prevent intergenerational stunting.

• Clinical and Experimental Pediatrics
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• 제62권3호
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• pp.102-107
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• 2019

Purpose: This study compared the iron statuses of small for gestational age (SGA) and appropriate for gestational age (AGA) infants at birth. Methods: The clinical data of 904 newborn infants admitted to the neonatal intensive care unit were reviewed. Blood samples were drawn from the infants within 24 hours after birth. Serum ferritin level was used as a marker of total iron status. Results: In this study, 115 SGA (GA, $36.5{\pm}2.9weeks$; birth weight [BW], $1,975{\pm}594.5g$) and 717 AGA (GA, $35.1{\pm}3.5weeks$; BW, $2,420.3{\pm}768.7g$) infants were included. The SGA infants had higher hematocrit levels ($50.6%{\pm}5.8%$ vs. $47.7%{\pm}5.7%$, P<0.05) than the AGA infants. No difference in serum ferritin level (ng/mL) was found between the groups (mean [95% confidence interval]: SGA vs. AGA infants, 139.0 [70.0-237.0] vs. 141.0 [82.5-228.5]). After adjusting for gestational age, the SGA infants had lower ferritin levels (147.1 ng/mL [116.3-178.0 ng/mL] vs. 189.4 ng/mL [178.0-200.8 ng/mL], P<0.05). Total body iron stores were also lower in the SGA infants than in the AGA infants (185.6 [153.4-211.7] vs 202.2 [168.7-241.9], P<0.05). Conclusion: The SGA infants had lower ferritin and total body iron stores than the AGA infants. The SGA infants affected by maternal hypertension who were born at late preterm had an additional risk of inadequate iron store. Iron deficiency should be monitored in these infants during follow-up.

• Neonatal Medicine
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• 제25권4호
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• pp.170-177
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• 2018

Purpose: Preterm infants frequently require red blood cell (RBC) transfusions in neonatal intensive care units (NICU). Storage RBCs undergo many changes during storage periods. We aimed to compare the hemoglobin (Hb) correction effect according to the period of RBC storage and investigate the factors influencing Hb correction. Methods: This retrospective study reviewed the medical records of 289 patients who received RBC transfusion more than once in the NICU of Kosin University Gospel Hospital between February 2006 and March 2016. The subjects were classified into two storage groups: short-term (${\leq}7days$, n=88) and long-term (>7 days, n=201), according to the period of RBC storage. We checked Hb levels by complete blood cell count tests conducted within 2 days before and 5 to 9 days after the first transfusion. We compared the Hb difference between the two groups and analyzed the factors influencing Hb correction. Results: Excluding the use of an invasive ventilator, there was no significant difference between the two groups in terms of clinical characteristics. There was no significant difference in the Hb correction effect between the two groups (P=0.537). Birth weight greater than 1,500 g, higher weight at transfusion, and larger volume of transfusion were significant prognostic factors affecting greater changes in Hb. In addition, surgery experience, higher Hb level at transfusion, and additional blood tests were found to be significantly associated with less changes in Hb. Conclusion: The RBC storage period did not affect the Hb correction effect. The Hb correction effect may be diminished in infants with lower birth weight and lower weight at transfusion under unstable clinical conditions.

• 병원약사회지
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• 제35권4호
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• pp.400-408
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• 2018

Background : Palivizumab is an intravenous monoclonal antibody which is used in the prevention of respiratory syncytial virus (RSV) infection. It is currently recommended for infants who are at high-risk for RSV infections due to preterm birth or other medical conditions such as congenital heart disease. Palivizumab is a humanized monoclonal antibody directed against an epitope in the antigenic site A of the protein F of RSV particles. Palivizumab is given once a month via intramuscular (IM) injection throughout the duration of the RSV season. Since palivizumab is known to have preventive effects against RSV infection for children with older siblings, the insurance coverage for palivizumab was expanded in October 2016. Methods : The electronic medical records of children under 2 years old who have older siblings who visited or were admitted to the Severance Hospital from October 2015 to May 2016 and from October 2016 to May 2017 were reviewed retrospectively. The data were then divided into two groups depending on the pilivizumab administration. Results : A total of 67 patients were enrolled in this study. The effectiveness in the reduction of hospitalization was statistically significant (p=0.009). Palivizumab decreased respiratory symptoms such as cough, rhinorrhea, and fever in patients with older siblings (p 0.05). Conclusions : In this study, palivizumab administration was effective in preventing RSV infection in infants with older siblings. Expanding palivizumab-prophylaxis administration to infants with older siblings may be effective in the prevention of upper respiratory infections.

• Journal of Genetic Medicine
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• 제18권2호
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• pp.110-116
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• 2021

Microdeletions of chromosome 22q11.2 are one of the most common microdeletions occurring in humans, and is known to be associated with a wide range of highly variable features. These deletions occur within a cluster of low copy repeats (LCRs) in 22q11.2, referred to as LCR22 A-H. DiGeorge (DGS)/velocardiofacial syndrome is the most prevalent form of a 22q11.2 deletions, caused by mainly proximal deletions between LCR22 A and D. As deletions of distal portion to the DGS deleted regions has been extensively studied, the recurrent distal 22q11.2 microdeletions distinct from DGS has been suggested as several clinical entities according to the various in size and position of the deletions on LCRs. We report a case of long-term follow-up of a female diagnosed with a 22q11.2 distal deletion syndrome, identified a deletion of 1.9 Mb at 22q11.21q11.23 (chr22: 21,798,906-23,653,963) using single nucleotide polymorphism array. This region was categorized as distal deletion type of 22q11.2, involving LCR22 D-F. She was born as a preterm, low birth weight to healthy non-consanguineous Korean parents. She showed developmental delay, growth retardation, dysmorphic facial features, and mild skeletal deformities. The patient underwent a growth hormone administration due to growth impairment without catch-up growth. While a height gain was noted, she had become overweight and was subsequently diagnosed with pre-diabetes. Our case could help broaden the genetic and clinical spectrum of 22q11.2 distal deletions.