• Title/Summary/Keyword: Small for gestational age

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Estimation of Gestational Age by Measurement of Deep Portion of Telencephalic Vesicle in Pekingese Fetus

  • Park, Jun-Tae;Park, Chul-Ho;Oh, Ki-Seok;Son, Chang-Ho
    • Journal of Embryo Transfer
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    • v.29 no.4
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    • pp.369-373
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    • 2014
  • This study was performed to establish a new parameter for estimating gestational age and predicting parturition day by ultrasonographic measurement of deep portion of telencephalic vesicle (DPTV) diameter in small dogs. Fetal head diameter (HD) and DPTV diameter were measured in 15 pregnant Pekingese bitches, from Day 15 to the parturition day, and evaluated the correlation between gestational age. HD was measured from day 29 of pregnancy to parturition day and increased from $4.9{\pm}2mm$ to $25.5{\pm}0.7mm$. Especially, from day 38 of pregnancy to parturition day, HD uniformly increased about 0.6 mm per day and was significantly and linearly relative to gestational age during this period ($r^2$ >0.99). DPTV diameter was measured from day 35 to day 60 of pregnancy and increased from $3.2{\pm}0.9mm$ to $11.5{\pm}0.7mm$. Especially from day 38 to day 60 of pregnancy, DPTV diameter uniformly increased about 1 mm per 3 days and was significantly and linearly relative to gestational age during this period ($r^2$ >0.99). In conclusion, DPTV diameter could to be a useful parameter for the estimation of gestational age and the prediction of parturition day when used alone or in combination with HD during the second half of pregnancy.

Postdischarge growth assessment in very low birth weight infants

  • Park, Joon-Sik;Han, Jungho;Shin, Jeong Eun;Lee, Soon Min;Eun, Ho Seon;Park, Min-Soo;Park, Kook-In;Namgung, Ran
    • Clinical and Experimental Pediatrics
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    • v.60 no.3
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    • pp.64-69
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    • 2017
  • Purpose: The goal of nutritional support for very-low-birth-weight (VLBW) infants from birth to term is to match the in utero growth rates; however, this is rarely achieved. Methods: We evaluated postdischarge growth patterns and growth failure in 81 Korean VLBW infants through a retrospective study. Weight and height were measured and calculated based on age percentile distribution every 3 months until age 24 months. Growth failure was defined as weight and height below the 10th percentile at 24 months. For the subgroup analysis, small-for-gestational age (SGA) and extremely low birth weight (ELBW) infants were evaluated. The growth patterns based on the Korean, World Health Organization (WHO), or Centers for Disease Control and Prevention (CDC) standard were serially compared over time. Results: At postconception age (PCA) 40 weeks, 47 (58%) and 45 infants (55%) showed growth failure in terms of weight and height, respectively. At PCA 24 months, 20 infants (24%) showed growth failure for weight and 14 (18%) for height. Growth failure rates were higher for the SGA infants than for the appropriate-weight-for-gestational age infants at PCA 24 months (P=0.045 for weight and P=0.038 for height). Growth failure rates were higher for the ELBW infants than for the non-ELBW infants at PCA 24 months (P<0.001 for weight and P=0.003 for height). Significant differences were found among the WHO, CDC, and Korean standards (P<0.001). Conclusion: Advancements in neonatal care have improved the catch-up growth of VLBW infants, but this is insufficient. Careful observation and aggressive interventions, especially in SGA and ELBW infants, are needed.

Association between small for gestational age and risk of autism spectrum disorders: a meta-analysis

  • Jenabi, Ensiyeh;Bashirian, Saeid;Asali, Zahra;Seyedi, Mahdieh
    • Clinical and Experimental Pediatrics
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    • v.64 no.10
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    • pp.538-542
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    • 2021
  • Background: The relationship between small for gestational age (SGA) and autism spectrum disorders (ASDs) remains unknown. Purpose: This meta-analysis aimed to investigate the relationship between SGA and the risk of ASD. Methods: We searched PubMed, Web of Science, and Scopus databases from inception to November 2020. The heterogeneity across studies was explored using the I2 statistic. The possibility of publication bias was assessed using Begg test. The results were reported using the odds ratio (OR) and 95% confidence interval (CI) using a random-effects model. Results: The literature search yielded 824 articles with 8,752,138 participants. We assessed the association between SGA and the risk of ASD in cohort and case-control studies. Based on the random-effects model, compared with SGA, the estimated OR of the risk of ASD was 1.17 (95% CI, 1.09-1.24). Therefore, there was a significant association between SGA and the risk of ASD. Conclusion: Based on OR reports in epidemiological studies, we showed that SGA is a risk factor for and can increase the risk of ASD. The association between SGA and ASD risk has further relevance to the current public health emphasis on appropriate prepregnancy weight and pregnancy weight gain.

Catch-up growth and catch-up fat in children born small for gestational age

  • Cho, Won Kyoung;Suh, Byung-Kyu
    • Clinical and Experimental Pediatrics
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    • v.59 no.1
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    • pp.1-7
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    • 2016
  • Infants born small for gestational age (SGA) are at increased risk of perinatal morbidity, persistent short stature, and metabolic alterations in later life. Recent studies have focused on the association between birth weight (BW) and later body composition. Some reports suggest that fetal nutrition, as reflected by BW, may have an inverse programing effect on abdominal adiposity later in life. This inverse association between BW and abdominal adiposity in adults may contribute to insulin resistance. Rapid weight gain during infancy in SGA children seemed to be associated with increased fat mass rather than lean mass. Early catch-up growth after SGA birth rather than SGA itself has been noted as a cardiovascular risk factor in later life. Children who are born SGA also have a predisposition to accumulation of fat mass, particularly intra-abdominal fat. It is not yet clear whether this predisposition is due to low BW itself, rapid postnatal catch-up growth, or a combination of both. In this report, we review the published literature on central fat accumulation and metabolic consequences of being SGA, as well as the currently popular research area of SGA, including growth aspects.

TORCH (toxoplasmosis, rubella, cytomegalovirus, and herpes simplex virus) screening of small for gestational age and intrauterine growth restricted neonates: efficacy study in a single institute in Korea

  • Chung, Mi Hae;Shin, Chan Ok;Lee, Juyoung
    • Clinical and Experimental Pediatrics
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    • v.61 no.4
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    • pp.114-120
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    • 2018
  • Purpose: Routine screening for toxoplasmosis, rubella, cytomegalovirus (CMV), and herpes simplex virus (TORCH) in intrauterine growth restriction (IUGR) and small for gestational age (SGA) neonates has become a common practice. However, the incidence of TORCH varies across countries, and the cost of TORCH testing may be disadvantageous compared to disease-specific screening. To evaluate the efficacy of TORCH screening, the medical charts of IUGR or SGA neonates born in a single institution in Bucheon, Korea from 2011 to 2015 were reviewed. Methods: The clinical data of the 126 IUGR or SGA neonates were gathered, including gestational age, Apgar scores, neonatal sonographic findings, chromosome study, morbidities, developmental follow-up, and growth catch-up. Maternal factors including underlying maternal disease and fetal sonography were collected, and placental findings were recorded when available. TORCH screening was done using serum IgM, CMV urine culture, quantification of CMV DNA with real-time polymerase chain reaction, and rapid plasma reagin qualitative test for syphilis. Tests were repeated only for those with positive results. Results: Of the 119 TORCH screenings, only one was positive for toxoplasmosis IgM. This result was deemed false positive due to negative IgM on repeated testing and the absence of clinical symptoms. Conclusion: Considering the incidence and risk of TORCH in Korea, the financial burden of TORCH screening, and the single positive TORCH finding in our study, we suggest disease-specific screening based on maternal history and the clinical symptoms of the neonate. Regarding CMV, which may present asymptomatically, universal screening may be appropriate upon cost-benefit analysis.

Growth Curve of the Gestational Structures by Ultrasonography Examination in Small Pet Dogs (소형 애완견에서 초음파 검사에 의한 임신 구조물의 성장 곡선)

  • Oh, Ki-Seok;Kim, Bang-Sil;Park, Sang-Guk;Park, Chul-Ho;Kim, Jae-Hong;Mun, Byeong-Gwon;Kim, Hee-Su;Lee, Ju-Hwan;Park, In-Chul;Kim, Jong-Taek;Suh, Guk-Hyun;Son, Chang-Ho
    • Journal of Embryo Transfer
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    • v.23 no.3
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    • pp.147-153
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    • 2008
  • Serial ultrasonographic examinations were daily performed from 15 days after ovulation until parturition to determine the growth curve of gestational structures in pregnant Maltese, Yorkshire terrier, Shih-tzu, and Miniature Schnauzer bitches, respectively. Gestational age was timed from the day of ovulation (day 0), which was estimated to occur when plasma progesterone concentration was first increased above 4.0 ng/ml. The inner chorionic cavity diameter were significantly and linearly relative to gestational age especially days 20 to 40, and the fetal head diameter were significantly and linearly relative to gestational age especial1y day 40 to parturition. These results indicate that inner chorionic cavity diameter were the most accurate for estimating gestational age before day 38 of gestation and the fetal head diameter were after day 38 of gestation.

Current use of growth hormone in children (성장호르몬 치료의 최신 지견)

  • Shin, Choong Ho
    • Clinical and Experimental Pediatrics
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    • v.49 no.7
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    • pp.703-709
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    • 2006
  • Since the advent of growth hormone(GH), children with a wide variety of growth disorders have received GH treatment. In GH deficiency(GHD), Turner syndrome, chronic renal failure, children born small for gestational age, Prader-Willi syndrome, and idiopathic short stature, the therapeutic effects and safety profile of GH are reviewed. GH therapy has been clearly shown to improve height velocity and final adult height in a variety of pediatric conditions in which growth is compromised irrespective of GHD. Early initiation and individualization of GH treatment has the potential to normalize childhood growth. The supra-physiological doses of GH have been shown to increase height velocity during childhood and final height in non-GHD conditions. Adverse events during GH therapy are uncommon and often not drug related. However continued surveillance into adult life is crucial, especially in children receiving supra-physiological doses or whose underlying condition increases their risk of adverse effects.

Growth patterns and nutritional status of small for gestational age infants in Malaysia during the first year of life

  • Ahmad, Norain;Sutan, Rosnah;Tamil, Azmi Mohd;Hajib, Noriah
    • Child Health Nursing Research
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    • v.27 no.4
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    • pp.317-327
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    • 2021
  • Purpose: This study aimed to identify small for gestational age (SGA) infants' growth patterns, nutritional status, and associated factors. Methods: This prospective cohort study was conducted at primary-care child health clinics in Greater Kuala Lumpur, Malaysia. The sample consisted of infants who fulfilled the criteria and were born in 2019. The anthropometric data of infants were assessed at birth and at 1, 3, 6, 9, and 12 months. Results: A total of 328 infants were analysed. In total, 27.7%(n=91) of the subjects were SGA infants, and 237 of them were not. Significant differences in the median weight-for-age and length-for-age z-scores were observed between SGA and non-SGA infants at birth, 1 month, 6 months, and 12 months. There was a significant difference between the growth patterns of SGA and non-SGA infants. Birth weight and sex significantly predicted the nutritional status(stunting and underweight) of SGA infants during their first year of life. Conclusion: SGA infants can catch up to achieve normal growth during their first year of life. Even though the nutritional status of SGA infants trends worse than non-SGA infants, adequate infant birth weight monitoring and an emphasis on nutritional advice are crucial for maintaining well-being.

Maternal and neonatal outcomes in Korean women with type 2 diabetes

  • Jang, Hye-Jung;Kim, Hee-Sook;Kim, Sung-Hoon
    • The Korean journal of internal medicine
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    • v.33 no.6
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    • pp.1143-1149
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    • 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.

Analysis of anthropometric data for premature infants of 26 to 35 weeks of gestation; comparison with the data of 1960's (재태연령 26주 이상 35주 이하 미숙아의 신체계측치의 분석; 1960년대 측정치와의 비교)

  • Aum, Ji A;Jung, Hee Jin;Huh, Jae Won;Son, Sang Hee
    • Clinical and Experimental Pediatrics
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    • v.50 no.6
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    • pp.543-548
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    • 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.