• Title/Summary/Keyword: gestational age

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Nutritional strategy of early amino acid administration in very low birth weight infants

  • Lee, Byong Sop
    • Clinical and Experimental Pediatrics
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    • v.58 no.3
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    • pp.77-83
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    • 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.

Influence of Gestational Age at Exposure on the Prenatal Effects of Gamma-Radiation

  • Kim, Sung-ho;Lee, Jong-hwan;Heon Oh;Kim, Se-ra;Jo, Sung-kee
    • Proceedings of the Korean Society of Veterinary Pathology Conference
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    • 2000.09a
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    • pp.20-20
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    • 2000
  • The objective of this investigation was to evaluate of influence of gestational age at exposure on the prenatal effects of gamma-radiation. Pregnant ICR mice were exposed to single dose of 2.0 Gy gamma-radiation at gestation days from 2.5 to 15.5 days post-coitus. The animals were sacrificed on day 18 of gestation and the fetuses were examined for mortality, growth retardation, change in head size and any other morphological abnormalities. The only demonstrable effect of irradiation during the pre-implantation period was an increase in prenatal mortality. (omitted)

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A System Dynamics Model for Growth Prediction of Low Birth Weight Infants (시스템다이내믹스를 이용한 저출생체중아의 성장예측모형)

  • Yi, Young-Hee
    • Korean System Dynamics Review
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    • v.11 no.3
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    • pp.5-31
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    • 2010
  • The purpose of this study is to develop a system dynamics model for growth prediction of low birth weight infants(LBWIs) based on nutrition. This growth prediction model consists of 9 modules; body weight, height, carbohydrate, protein, lipid, micronutrient, water, activity and energy module. The results of the model simulation match well with the percentiles of weights and heights of the Korean infants, also with the growth records of 55 LBWIs, under 37 weeks of gestational age, whose weights are appropriate for their gestational age. This model can be used to understand the current growth mode of LBWIs, predict the future growth of LBWIs, and be utilized as a tool for controlling the nutrient intake for the optimal growth of LBWIs in actual practice.

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Autoradiographic Observations on Variation of DNA Synthesis in the Developing Extraembryonic Membranes of the Golden Hamster (Golden Hamster 태반형성(胎盤形成)에 있어서 Autoradiography에 의한 분열세포(分裂細胞)의 소장(消長))

  • Lee, Cha-Soo
    • Korean Journal of Veterinary Research
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    • v.23 no.1
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    • pp.1-8
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    • 1983
  • The purpose of the present study is to determine variations in synthesis of DNA in the nuclei of various elements of the golden hamster (Mesocricetus auratus) placenta with increasing gestational age from the eighth day post coitus to parturition. The method employed for such determination was autoradiography following injection of pregnant animals with tritiated thymidine. From the results reported, the following points are concluded. The mitotic activities of the endodermal cells of the visceral yolk sac and of the parietal yolk sac, the trophoblastic cells of the labyrinth and the trophospongium and the giant cells were decreased with increasing gestational age, The placentation was nearly completed by day 13 of pregnancy and the increase in size of labyrinth was by appositional growth from the trophospongial cells. It was considered that the inner trophoblastic cells in the vicinity of the fetal blood vessels were originated from the pure chorion. The interrelation among the various cells and the polyploidal giant cells in the placenta were discussed.

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A Study on the Bone Density in Newborn Infants - Difference of the Bone Mineral Density according to the Gestational Age and the Birth Weight - (신생아 골밀도에 관한 연구 - 재태 연령과 출생 체중에 따른 골밀도의 차이 -)

  • Lee, Eun-Sil;Shin, Son-Moon;Moon, Han-Ku;Park, Yong-Hoon;Choi, Kwang-Hae
    • Journal of Yeungnam Medical Science
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    • v.14 no.2
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    • pp.383-392
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    • 1997
  • To study the differences of bone mineral density according to the gestational ages and the birth weight and get a reference data for the diagnosis of metabolic bone diseases in the newborn infants, bone mineral densities of the lumbar vertebrae were measured in fifty-three newborn infants born at Yeungnam University Hospital from March 1, 1995 to February 28, 1997, whore gestational ages were between $28^{+3}$ and $41^{+3}$ weeks and who had no intrauterine growth retardation, using dual energy X-ray absorptiometry (X-R 26, Norland, USA) within seven days of life. 1. There was no sexual difference in bone mineral density. The bone density increased significantly as gestational age increased from $0.149{\pm}0.009g/cm^2$ at 28-30wks to $0.229{\pm}0.034g/cm^2$ at 39-41wks of gestational age (p<0.05), but there was no significant difference between bone mineral densities at 33-34 wks and 35-36wks. There was positive linear correlation between gestational age and bone mineral density ($Y=7.5{\times}10^{-3}X-0.082$, r=0.7018, p<0.001). 2. The bone mineral density increased significantly as the birth weight increased from $0.158{\pm}0.020g/cm^2$ in 1,000-1,499 g to $0.251{\pm}0.021g/cm^2$ in 3,500-4,000 g of the birth weight (p<0.05), but there was no significant difference between bone mineral densities in 1,000-1,499 g and 1,500-1,999 g of the birth weight. There was positive linear correlation between the birth weight and the bone mineral density ($Y=3.9{\times}10^{-5}X+0.093$, r=0.7296, p<0.001). There were positive correlations between the bone mineral density and gestational age, and between the bone mineral density and the birth weight. It can be used as a reference data for the further study on the bone mineral metabolism in the newborn infants including preterm babies.

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Concurrence of Obstetric Brachial Plexus Injury, Congenital Muscular Torticollis and Cleft Palate (분만성 상완 신경총 손상, 선천성근성사경 및 구개열의 병발)

  • Lee, Han-Byul;Park, Myong-Chul;Kim, Chee-Sun;Han, Jae-Deok;Lee, Seung-Jae;Kim, Se-Yon;Yim, Shin-Young
    • Journal of Genetic Medicine
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    • v.8 no.1
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    • pp.71-75
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    • 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.

Time of Initial Detection of the Gestational Structures by Ultrasonography Examination in Small Pet Dogs (소형 애완견에서 초음파 검사에 의한 임신 구조물의 최초 관찰 시기)

  • Park, Sang-Guk;Kim, Bang-Sil;Yun, Chang-Jin;Yeo, Woon-Chang;Park, Chul-Ho;Kim, Jae-Pung;Lee, Suk-Kyung;Moon, Jin-San;Suh, Guk-Hyun;Oh, Ki-Seok;Son, Chang-ho
    • Journal of Embryo Transfer
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    • v.23 no.1
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    • pp.5-11
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    • 2008
  • Serial ultrasonographic examinations were daily performed from 15 days after ovulation until parturition to determine the time of first detection and ultrasonographic appearance of the fetal and extra-fetal structures in pregnant 10 Maltese, 10 Yorkshire Terrier, 15 Shih-tzu, and 10 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 4.0ng/ml. The gestational length was $63.4{\sim}63.6$ (range: $61{\sim}65$) days and the geatational length was no statistically significant difference among bitches (p>0.05). The initial detection of the extra-fetal structures were; gestational sac at days $18.9{\sim}19.5\;(17{\sim}22)$, zonary placenta at days $24.6{\sim}25.5\;(23{\sim}28)$, yolk sac membrane at days $24.6{\sim}25.5\;(23{\sim}27)$, yolk sac tubular shape at days $26.1{\sim}26.3\;(24{\sim}28)$, and amniotic membrane at days $26.1{\sim}28.2\;(24{\sim}31)$, respectively. The time of the first detection of the extra-fetal structures were no statistically significant difference among bitches (p>0.05). The initial detection of the fetal structures were; embryo initial detection at days $22.5{\sim}22.9\;(21{\sim}24)$, heartbeat at days $23.2{\sim}23.8\;(21{\sim}25)$, embryo bipolar shape $27.6{\sim}28.9\;(26{\sim}30)$, fetal movement at days $31.9{\sim}32.8\;(27{\sim}34)$, limb buds at days $29.1{\sim}30.7\;(27{\sim}33)$, stomach at days $31.1{\sim}33.1\;(29{\sim}34)$, urinary bladder at days $32.4{\sim}33.2\;(29{\sim}35)$, skeleton at days $34.7{\sim}35.9\;(34{\sim}39)$, and kidney at days $42.1{\sim}44.7\;(41{\sim}48)$, respectively. The the time of the first detection of the fetal structures were no statistically significant difference among bitches (p>0.05). These results indicate the evaluation of the time of first detection and ultrasonographic characteristics of the gestational structures might be useful for pregnancy diagnosis, estimating fetal age, embryonic resorption, fetal monster, abnormal fetal growth and fetal viability, respectively.

Effects of Gestational Status on Apparent Absorption and Retention of Copper and Zinc in Mature Angus Cows and Suffolk Ewes

  • Vierboom, M.M.;Engle, T.E.;Kimberling, C.V.
    • Asian-Australasian Journal of Animal Sciences
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    • v.16 no.4
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    • pp.515-518
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    • 2003
  • Six mature purebred Angus cows ($3.5{\pm}1.5$ years of age, $631.36{\pm}8.63kg$), three pregnant ($250{\pm}7$ days pregnant) and three non-pregnant and eight mature Suffolk ewes ($5{\pm}1.2$ years of age, $68.18{\pm}2.3kg$) four pregnant $115{\pm}5$ days pregnant) and four nonpregnant were utilized in a five-day metabolic trial to determine the effects of gestational status (pregnant vs. non-pregnant) on apparent absorption and retention of copper (Cu) and zinc (Zn). Animals were selected based on body weight, age, and gestational status, and randomly assigned to metabolic crates for total fecal and urine collection. Animals were allowed to acclimate to their new environment for seven days. Pregnant and non-pregnant cows and ewes were then paired (within a species) by body weight and pair-fed throughout the 5 day collection period. Copper and Zn intakes were similar for pregnant and non-pregnant animals within a species. Apparent absorption of Cu (p<0.06) and Zn (p<0.04) were higher in pregnant cows relative to non-pregnant cows. Pregnant cows also had a higher apparent retention of Cu (p<0.05) and Zn (p<0.06) relative to non-pregnant cows. Pregnant ewes had a higher (p<0.01) apparent absorption and retention of Zn compared to non-pregnant ewes. However, apparent absorption and retention of Cu were similar for pregnant and non-pregnant ewes. These data indicate that certain physiological and/or metabolic parameters are altered in pregnant cows and ewes consuming an alfalfa-based diet that enhance the apparent absorption and retention of certain trace minerals.

Development of a Premature Infant Pain Scale (PIPS) (미숙아 통증지표(Premature Infant Pain Scale) 개발)

  • Kim, Mi-Soon;Kim, Mi-Jin;Ham, Eun-Ha;Kim, Kyoung-Mi
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.13 no.3
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    • pp.510-519
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    • 2006
  • Purpose: To develop and validate a scale suitable and efficient scale for use in clinical practice as to assess pain in premature infants. Method: Pain indicators identified by observation of preform infants. A cohort of preform infants was studied prospectively to determine the construct validity, inter-rater reliability, and internal consistency of the scale. The PIPS uses four indicators of pain: corrected gestational age, heart rate, oxygen saturation, behavioral state. The validation study included 45 premature infants with gestational age of 37 weeks or less. Results: The inter-rater reliability of the PIPS was acceptable, with Pearson correlations ranging from.720 to.970. Internal consistency was high: Cronbach's alpha coefficients ranged from.551 to.653. There was a strong correlation between the PIPS and PIPP scores (each researcher's r=.743, each indicator's r=.914). Although gestational age showed no association between these factors and the sum, the other variables were positively associated with the sum. Time needed to calculate PIPS scores is was less than Premature Infant Pain Profile (PIPP) scores(p<.000). Conclusion: The validation data suggest that the PIPS is appropriate and efficient for assessing pain in premature infants. Further studies are required about to determine appropriate interventions for each pain score on the PIPS.

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Respiratory Severity Score as a Predictive Factor for the Mortality of Congenital Diaphragmatic Hernia

  • Ahn, Ja-Hye;Jung, Young Hwa;Shin, Seung Han;Kim, Hyun-Young;Kim, Ee-Kyung;Kim, Han-Suk
    • Neonatal Medicine
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    • v.25 no.3
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    • pp.102-108
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    • 2018
  • Purpose: Congenital diaphragmatic hernia (CDH) is rare but potentially fatal. The overall outcome is highly variable. This study aimed to identify a simple and dynamic parameter that helps predict the mortality of CDH patients in real time, without invasive tests. Methods: We conducted a retrospective chart review of 59 CDH cases. Maternal and fetal information included the gestational age at diagnosis, site of defect, presence of liver herniation, and lung-to-head ratio (LHR) at 20 to 29 weeks of gestational age. Information regarding postnatal treatment, including the number of days until surgery, the need for inhaled nitric oxide (iNO), the need for extracorporeal membrane oxygenation (ECMO), and survival, was collected. The highest respiratory severity score (RSS) within 24 hours after birth was also calculated. Results: Statistical analysis showed that a younger gestational age at the initial diagnosis (P<0.001), a lower LHR (P=0.001), and the presence of liver herniation (P=0.003) were prenatal risk factors for CDH mortality. The RSS and use of iNO and ECMO were significant factors affecting survival. In the multivariate analysis, the only remaining significant risk factor was the highest preoperative RSS within 24 hours after birth (P=0.002). The area under the receiver operating characteristic curve was 0.9375, with a sensitivity of 91.67% and specificity of 83.87% at the RSS cut-off value of 5.2. The positive and negative predictive values were 82.14% and 92.86%, respectively. Conclusion: Using the RSS as a prognostic predictor with simple calculations will help clinicians plan CDH management.