• Clinical and Experimental Pediatrics
• /
• v.54 no.6
• /
• pp.246-252
• /
• 2011

Purpose: The outcomes of small for gestational age (SGA) infants especially in extremely low birth weight infants (ELBWIs) are controversial. This study evaluated the mortality and morbidity of ELBWIs, focusing on whether or not they were also SGA. Methods: The medical records of 415 ELBWIs (birth weight<1,000 g), who were inborn and admitted to the Samsung Medical Center neonatal intensive care unit from January 2000 to December 2008, were reviewed retrospectively. Mortality and morbidities were compared by body size groups: very SGA (VSGA), birth weight ${\leq}$3rd percentile; SGA, 3rd to 10th percentile; and appropriate for gestational age (AGA) infants, >10th percentile for gestational age. For gestational subgroup analysis, groups were divided into infants with gestational age ${\leq}24^{+6}$ weeks (subgroup I), $25^{+0}$ to $26^{+6}$ weeks (subgroup II), and ${\geq}27^{+0}$ weeks (subgroup III) Results: Gestational age was $29^{+2}{\pm}2^{+6}$ weeks in the VSGA infants (n=49), $27^{+5}{\pm}2^{+2}$weeks in the SGA infants (n=45), and $25^{+4}{\pm}1^{+4}$ weeks in AGA infants (n=321). Birth weight was $692{\pm}186.6$ g, $768{\pm}132.9$ g, and $780{\pm}142.5$ g in the VSGA, SGA, and AGA groups, respectively. Cesarean section rate and maternal pregnancy-induced hypertension were more common in the VSGA and SGA than in AGA pregnancies. However, chorioamnionitis was more common in the AGA group. The mortalities of the lowest gestational group (subgroup I), and also of the lower gestational group (subgroup I+II) were significantly higher in the VSGA group than the SGA or AGA groups (P=0.020 and P=0.012, respectively). VSGA and SGA infants showed lower incidence in respiratory distress syndrome, ductal ligation, bronchopulmonary dysplasia, intraventricular hemorrhage than AGA group did. However, by multiple logistic regression analysis of each gestational subgroup, the differences were not significant. Conclusion: Of ELBWIs, extremely SGA in the lower gestational subgroups, had an impact on mortality, which may provide information useful for prenatal counseling.

• Clinical and Experimental Pediatrics
• /
• v.62 no.3
• /
• pp.102-107
• /
• 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.

• Clinical and Experimental Pediatrics
• /
• v.53 no.6
• /
• pp.688-693
• /
• 2010

An increase in the number of preterm infants and a decrease in the gestational age at birth have resulted in an increase in the number of patients with significant bronchopulmonary dysplasia (BPD) and secondary pulmonary hypertension (PH). PH contributes significantly to the high morbidity and mortality in the BPD patients. Therefore, regular monitoring for PH by using echocardiography and B-type natriuretic peptide (BNP) or N-terminal-proBNP must be conducted in the BPD patients with greater than moderate degree to prevent PH and to ensure early treatment if PH is present. In the BPD patients with significant PH, multi-modality treatment, including treatment for correcting an underlying disease, oxygen supply, use of diverse selective pulmonary vasodilators (inhaled nitric oxide, inhaled prostacyclins, sildenafil, and endothelin-receptor antagonist) and other methods, is mandatory.

• The Journal of Korean Obstetrics and Gynecology
• /
• v.33 no.3
• /
• pp.119-135
• /
• 2020

Objectives: The purpose of this study is to confirm the effectiveness and safety of herbal medicine treatment for treating pregnancy-induced hypertension. Methods: We searched for randomized controlled trials of pregnancy-induced hypertension treated with herbal medicine, through nine databases. Interventions and results of the selected clinical studies were analyzed. Results: Eleven randomized controlled trials were finally included according to the inclusion and exclusion criteria. Treatment group was treated with herbal medicine alone in two studies, and with herbal medicine and western medicine in nine studies. Control group was treated with western medicine. Taxilli Ramulus (桑寄生) (54.5%) was the most frequently used herb in herbal medicine treatment. In all of eleven studies, treatment group was more effective for pregnancy-induced hypertension than the control group. Conclusions: This study suggested that herbal medicine treatment alone or combined with western medicine treatment could be helpful in improving the therapeutic effect on pregnancy-induced hypertension and reducing side effects as well. However, in order to obtain stronger evidence of herbal medicine treatment for pregnancy-induced hypertension, more high-quality and well-designed randomized controlled trials should be conducted.

• Journal of Preventive Medicine and Public Health
• /
• v.24 no.3 s.35
• /
• pp.356-362
• /
• 1991

This study was performed to identify the maternal risk factors for the low birth weight. During the period from February to June in 1991, the medical record review and questionnaire interview were conducted upon the 465 pregnant women who were admitted to and delivered a baby in 3 general hospitals and an obstetric hospital in Kwangju area. The health and other related information from women who bore the low birth weight infant was compared with those from women who bore the normal birth weight infant. The results obtained were as follows : 1. Maternal age, low body weight at term, illegitimate birth, and maintaining work activity during pregnancy were positively associated with low birth weight. 2. The positive association was revealed between low birth weight and the previous abortion, short gestational weeks, anemia, low maternal weight gain during pregnancy, the obstetric present illness and hypertension. 3. Some maternal working conditions were associated with low birth weight although statistically not significant. 4. In multivariate logistic regression analysis, gestational weeks and maternal weight gain during pregnancy were related with low birth weight.

• Clinical and Experimental Pediatrics
• /
• v.63 no.2
• /
• pp.48-51
• /
• 2020

Background: The etiopathogenesis of late preterm (LPT) birth is undetermined. Placental histopathology, which reflects an adverse intrauterine environment and is reportedly associated with preterm labor and neonatal morbidities, has not been studied in LPT infants. Purpose: We investigated placental pathological lesion as markers of an adverse intrauterine environment during LPT labor. Methods: This retrospective case-control study compared placental histopathological and clinical variables between LPT and term neonates. Placental variables included chorioamnionitis, funisitis, hemorrhage, abruption, infarction, calcification, and syncytial knots. Maternal variables included age, substance abuse, pregnancyassociated diabetes mellitus and hypertension, duration of rupture of membrane, antibiotic use, and magnesium sulfate, whereas, those of neonates included gestational age, birth weight, race, sex, and Apgar scores. Standard statistical proedures were applied to analyze the data. Results: Chorioamnionitis (50% vs. 17.8%, P<0.001) and funisitis (20% vs. 4.4%, P=0.002) were more common in term infants. Placental infarction rate was insignificantly higher in LPT infants (25.6% vs. 14.3%, P=0.08). The mothers in the LPT group were older (30.4 years vs. 28.1 years, P=0.05; odds ratio [OR], 1.06; 95% confidence interval [CI], 0.998-1.12, P=0.056) and more often suffered from hypertension (28.9 vs. 12.9 %, P=0.02), and received magnesium sulfate (48.9 vs. 20%, P< 0.001; OR, 2.86; 95% CI, 1.12-7.29, P<0.05). Duration of rupture of membrane was higher in term infants (13.6 hours vs. 9.1 hours, P<0.001). Chorioamnionitis (OR, 0.33; 95% CI, 0.13-0.79; P<0.05) was associated with a lower risk of LPT delivery. Conclusion: Placental infection is not a risk factor for LPT births. There is a nonsignificant predominance of vascular anomalies in LPT placentas. Higher maternal age, magnesium sulfate therapy, and maternal hypertension are clinical risk factors for LPT labor.

• Journal of Nutrition and Health
• /
• v.33 no.2
• /
• pp.186-192
• /
• 2000

In this study, total lipid and cholesterol contents and fatty acid composition of colostrum milk obtained from 30 normal mothers, 10 mothers who was delivered of preterm infant and 8 pregnancy induced hypertensive mothers were analyzed. While total cholesterol content in preterm colostrum was significantly lower than other groups (p<0.05), total lipid content was not different among three groups, ranged 2.24-.2.2g/dl. Composition of saturated fatty acide, such as lauric acid and myristic acid which are medium chain fatty acids in preterm milk were higher than those of normal-term and hypertensive mother's milk. There was no difference n total composition of polyunsaturated fatty acids and the rationh of $\omega$6/$\omega$3 among 3 group mother's colostrum, ranged 19.45-21.45% and 6.42-7.87, respectively. but the composition of arachidonic acid and DHA in colostrum of hypertensive mothers were significantly higher than those of normal and preterm mothers. These data indicates that gestational length and complications during pregnancy may change the lipid profile and fatty acid composition of hyman milk colosstrum.

• Childhood Kidney Diseases
• /
• v.27 no.2
• /
• pp.121-126
• /
• 2023

The administration of angiotensin type 2 receptor blockers (ARBs) during pregnancy is known to cause ARB fetopathy, including renal insufficiency. We aimed to analyze the outcomes of two patients who survived ARB fetopathy and perform an accompanying literature review. Case 1 was exposed antenatally from a gestational age of 30 weeks to valsartan because of maternal pregnancy-induced hypertension. The patient presented with oliguria immediately after birth, and renal replacement therapy was administered for 24 days. Seven years after birth, renal function was indicative of stage 2 chronic kidney disease (CKD) with impaired urinary concentration. Case 2 had a maternal history of hypertension and transient ischemic attack and was treated with olmesartan until 30 weeks of pregnancy. Renal replacement therapy was performed for 4 days since birth. After 8 years, the patient is with CKD stage 2, with intact tubular function. Recent reports suggest that ARB fetopathy might manifest as renal tubular dysgenesis and nephrogenic diabetes insipidus, in contrast to mild alterations of glomerular filtration. Tubular dysfunction may induce CKD progression and growth retardation. Patients with ARB fetopathy should be monitored until adulthood. The ARB exposure period might be a critical factor in determining the severity and manifestations of fetopathy.

• Biomedical Science Letters
• /
• v.13 no.1
• /
• pp.11-15
• /
• 2007

We examined the effects of pregnancy and pregnancy-induced hypertension (PIH) on platelet activation. Thirty-six women with PIH (blood pressure > 140/90 mm Hg after two consecutive measurements after the $24^{th}$ weeks of gestation) without proteinuria, fifty-six normotensive pregnant women, and fifty non-pregnant women were studied. WBC, RBC, platelet related variables, including mean platelet component (MPC), mean platelet volume (MPV) and platelet component distribution width (PCDW) were determined for this study. MPC levels were significantly lower in women with PIH compared with normotensive pregnant women and non-pregnant women (P<0.05). MPC levels were inversely con-elated with PIH (r=-0.49, P<0.001), systolic BP (r=-0.22, P<0.01), diastolic BP (r=-0.17, P<0.005), WBC (r=-0.30, P<0.001), MPV (r=-0.41, P<0.001), and PCDW (r=-0.68, P<0.001), and positively con-elated with RBC (r=0.32, P<0.001), platelet count (r=0.21, P<0.05), and mean platelet mass (MPM) (r=0.18, P<0.05). MPC levels were found to be an independent factor associated with PIH and PCDW (P<0.01) after adjustments were made for potential confounding factors such as gestational age, systolic blood pressure, diastolic blood pressure, WBC, RBC, Platelet count, and PCDW. In conclusion, MPC levels were significantly lower in women with PIH, and MPC levels were found to be an independent factor associated with PIH and PCDW. Therefore, platelet activation is suggested as a useful predictor for patients with PIH.

• The Korean Journal of Physiology and Pharmacology
• /
• v.22 no.4
• /
• pp.409-417
• /
• 2018

Pre-eclampsia (PE) is a pregnancy disorder that is characterised by severe hypertension and increased risks of foetal and maternal mortality. The aetiology of PE not completely understood; however, maternal nutrition and oxidative stress play important roles in the development of hypertension. The treatment options for PE are currently limited to anti-hypertensive drugs. Punicalagin, a polyphenol present in pomegranate juice, has a range of bioactive properties. The effects of supplementation with punicalagin on angiogenesis and oxidative stress in pregnant rats with induced hypertension were investigated. The pregnant rats were randomly divided into five experimental groups (n=12 per group). Hypertension was induced using an oral dose of NG-nitro-L-arginine methyl ester (L-NAME, 50 mg/kg/day) on days 14-19 of pregnancy. Punicalagin (25, 50 or 100 mg/kg) was given orally on days 14-21 of pregnancy. Punicalagin treatment at the tested doses significantly reduced diastolic, systolic, and mean arterial blood pressure in L-NAME treated rats from day 14. Punicalagin also restored angiogenic balance by increasing the expression of vascular endothelial growth factor and downregulating vascular endothelial growth factor receptor-1/fms-like tyrosine kinase-1. Punicalagin, significantly increased the placental nitric oxide levels as compared to PE group. The increased levels of oxidative stress in rats with PE were markedly decreased by treatment with punicalagin. Punicalagin at the tested doses markedly (p<0.05) enhanced the placental antioxidant capacity in L-NAME-treated rats. The raised catalase activity observed following L-NAME induction was significantly (p<0.05) and restored to normal activity levels in punicalagin treatment. Further, 100 mg dose of punicalagin exhibited higher protective effects as compared to lower doses of 25 and 50 mg. This study shows that supplementation with punicalagin decreased blood pressure and oxidative stress and restored angiogenic balance in pregnant rats with induced PE.