• Clinical and Experimental Pediatrics
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• v.50 no.10
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• pp.954-958
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• 2007

Purpose : The purpose of this study was to identify factors influencing premature infants who are small for their gestational ago. Methods : The medical records of 1,010 premature infants of 26 to 35 weeks of gestational age born at Il-Sin Christian Hospital, Busan from January 2000 to August 2006 were reviewed. We collected data on gestational age, birth weight, infant gender, birth order, maternal age and previous abortion history and analyzed the factors influencing premature infants who were small for their gestational ago at birth. Results : In our study more female than male (P=0.042) in premature infants who were small for their gestational ago were born from mothers aged younger than 20 or older than 35 (P=0.041). But association between smallness for gestational age and birth order or maternal previous abortion history was statistically insignificant (P=0.228, P=0.129). Conclusion : Considering the association of birth weight and the survival rate of premature infants, it is thought that maternal age had an influence on the survival rate of premature infants. Social and political support to lower the teenager pregnancy and older pregnancy is expected to increase the survival rate of premature infants and the birth of healthy normal neonates.

• Clinical and Experimental Pediatrics
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• v.59 no.10
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• pp.414-420
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• 2016

Purpose: We investigated behavioral problems, attention problems, and cognitive function in children and adolescents born small for gestational age (SGA). Methods: Forty-six SGA children born at term and 46 appropriate for gestational age (AGA) children born at term were compared. Psychiatric symptoms were examined with reference to the Korean-Child Behavior Checklist, Korean-Youth Self Report, and Attention Deficit Hyperactivity Disorder Rating Scale (ADHD-RS). Cognitive function was estimated using the Wechsler Intelligence Scale. Sociodemographic data were recorded from interviews. Results: SGA children had high scores on delinquent behavior, aggressive behavior, and the externalizing scale, and they also showed a propensity for anxiety and depression. The SGA group had a higher mean ADHD-RS score than the AGA group ($10.52{\pm}8.10$ vs.$9.93{\pm}7.23$), but the difference was not significant. The SGA group had a significantly lower verbal intelligence quotient (IQ) than the AGA group, but the mean scores of both groups were within normal limits. Conclusion: This study indicates marked behavioral problems, such as delinquency, aggressiveness, and anxiety and depression, as well as low verbal IQ in the SGA group than in the AGA group. Even in cases in which these symptoms are not severe, early detection and proper treatment can help these children adapt to society.

• Journal of Veterinary Clinics
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• v.21 no.1
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• pp.29-34
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• 2004

Serial ultrasonographic examinations were daily performed on 12 Shih-tzu bitches from 15 days after ovulation until parturition to determine the time of first detection and ultrasonographic appearance of the fetal and extra-fetal structures and to determine the size of gestational structures. 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 gestational length in 12 Shih-tzu bitches was 62.1 (range:60-64) days. The initial detection of the fetal and extra-fetal structures were: gestational sac at days 19.2 (16-21); zonary placenta in the uterine wall at days 25.9 (24-28); yolk sac membrane at days 24.1 (22-26); amniotic membrane at days 26.6 (24-28); embryo initial detection at days 22.3 (21-24); heartbeat at days 23.8 (23-25); limb buds at days 29.3 (27-31); fetal movement at days 32.3 (31-34); stomach at days 32.6 (29-34); urinary bladder at days 33.1 (29-35); skeleton at days 35.9 (34-38) and kidney at days 45.8 (45-48).

• 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.

• Applied Microscopy
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• v.23 no.1
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• pp.56-76
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• 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
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• v.52 no.2
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• pp.142-151
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• 2009

The incidence of small for gestational age (SGA) births is frequent, accounting for 2.3% to 8% of all live births. Several childhood and adult diseases are related to early postnatal growth and birth size, and 10% of children born SGA may have a short stature throughout postnatal life. Additionally, they may have abnormal growth hormone (GH)-insulin like growth factor axis, HPA axis, and gonadal function. Permanent changes are detrimental in an environment of nutritional abundance, and predispose SGA children to an array of diseases in adolescence and adulthood. Such changes may also cause premature pubarche, adrenarche, and precocious puberty. The varying results from clinical studies necessitate more prospective case control studies. Reproductive tract abnormalities and reproductive dysfunction are related to SGA births. GH treatment is required for SGA infants who do not experience catch-up growth.

• 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.

• Clinical and Experimental Pediatrics
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• v.61 no.3
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• pp.71-77
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• 2018

Purpose: Small for gestational age (SGA) is confusingly defined as birth weight (BW) either below 3rd percentile or 10th percentile for infants. This study aimed to compare postnatal catch-up growth between SGA groups according to different definitions. Methods: Data of 129 infants born with BW below the 10th percentile and admitted to Korea University Anam Hospital and Ansan Hospital were retrospectively reviewed. Height and weight were measured at 6, 12, and 24 months. Results were compared between group A (BW: <3rd percentile) and group B (BW: 3rd-10th percentile). Results: Group A included 66 infants and group B included 63. At age 6 months (n=122), 62.9% of group A and 71.7% (P=0.303) of group B showed catch-up growth in weight. At 6 months (n=69), 55.9% of group A and 80.0% of group B (P<0.05) showed catch-up growth in height. At 12 months (n=106), 58.5% of group A, and 75.5% (P=0.062) of group B showed catch-up growth in weight. At 12 months (n=75), 52.8% of group A and 64.1% of group B (P=0.320) showed catch-up growth in height. Up to age 24 months, 66.7%/80.0% in group A and 63.6%/80.0% in group B showed catch-up growth in weight/height. Conclusion: Despite different definitions, there were no significant differences between the two SGA groups in postnatal catch-up growth up to age 24 months, except for height at 6 months. Compared to infants with appropriate catch-up growth, low gestational age and BW were risk factors for failed catch-up growth at 6 months.

• Korean Journal of Community Nutrition
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• v.13 no.6
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• pp.805-817
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• 2008

The aim of this study was to determine the predictors of desirable pregnancy outcomes. The subjects were 795 pregnant women participating in the 2007 Mom and Baby Expo. They were grouped by gestational age: group I (3-12 wk: n = 95), group II (13-25 wks: n = 263) and group III (26-42 wks: n = 437). We collected data for general characteristics, sociocultural factors, life styles and nutrient intakes. We also collected pregnancy outcome data of 634 pregnant women including birth weight, maternal weight gain and gestational age. Dietary intakes of the subjects were estimated by Food Frequency Questionnaire. folate, iron and calcium intakes from foods of pregnant women were 88%, 79% and 58% of KDRIs, respectively. Bivariate analysis showed that birth weight was significantly associated with pre-pregnancy BMI, maternal weight gain, maternal age, gestational age and intakes of iron, potassium, $vitaminB_1$, $B_6$, fatty acids, MUFA. And also, bivariate analysis showed that maternal weight gain was significantly associated with pre-pregnancy BMI, maternal age, gestational age and intakes of energy, potassium. Further multivariate analyses suggest that vitaminB6 may be a significant predictor for low birth weight and energy intake and maternal age for maternal weight gain. Our findings suggest that dietary and lifestyle interventions during pregnancy can improve maternal and infant pregnancy outcomes. Prepregnancy weight control and intakes of energy and vitamin $B_6$ need to be taken into considerations in developing strategic prenatal care programs to promote desirable pregnancy outcome.

• Environmental Mutagens and Carcinogens
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• v.23 no.1
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• pp.1-6
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• 2003

The purpose of this study was to evaluate whether the MTHFR variants, folate and vitamin $B_{12}$ deficiencies increase the risk of hyperhomocysteinaemia and adverse pregnancy outcome such as short gestational age or reduced birth weight. Healthy pregnant women (n=136; 24-28 gestational weeks; 20-40 years old), who visited Ewha Womans University Hospital for prenatal care, participated in this study. At the time of delivery, trained nurses recorded the pregnancy outcome from medical chart. We determined maternal MTHFR polymorphisms (C to T subsitution at nucleotide 677) and measured serum homocyteine, vitamin $B_{12}$, and folate concentrations. We compared serum homocysteine level by MTHFR genotype, serum folate and serum vitamin B12 levels using ANOVA. To evaluate the association between serum homocysteine level and pregnancy outcome, we compared the gestational age and birth weight by serum homocysteine levels using multiple regression analysis, adjusting for other potential predictors. Mean level of serum homocysteine was highest among pregnant women of the MTHFR variants with low levels of serum folate and vitamin $B_{12}$. Regarding association with birth outcome, we found the relationship between homocysteine levels and increased gestational age (p=0.03) and reduced birth outcome (p>0.05). Our data demonstrates that serum level of folate and vitamin $B_{12}$ among pregnant women affects significantly serum homocysteine levels, and the genetic polymorphism of MTHFR modulates the relationship between them. However, we did not have conclusive evidence of association between high homocysteine level and adverse pregnancy outcome such as preterm or low birth weight.