Multicenter clinical study on birth weight and associated anomalies of single umbilical artery / 소아과

PURPOSE: To compare birth weight between infants with a single umbilical artery (SUA) and normal infants, investigate the associated anomalies of infants with SUA and isolated SUA (no abnormality of external appearance on birth, except SUA), and determine the prognosis of infants with isolated SUA. METHODS: Live-born infants with SUA (n=59) detected by physical examination from among 15,193 live births in seven university hospitals in Korea between January 1, 2004, to August 1, 2007, were reviewed retrospectively, with 236 normal infants serving as the control group. RESULTS: A statistical difference was observed between the groups in birth weight and in vitro fertilization. The incidence of infants with SUA was 0.37%. Congenital malformations were observed in 21 infants with cardiovascular (n=15, 25.4%), gastrointestinal (n=2, 3.4%), genitourinary (n=9, 15.3%), neuromusculoskeletal (n=6, 10.2%), central nervous system (n=1, 1.7%), chromosomal (n=1, 1.7%), and other (n=3, 5.1%) abnormalities. There were 49 (83.1%) infants with isolated SUA in this study population; among them, the associated congenital malformations were cardiovascular (n=6, 12.2%) and genitourinary (n=6, 12.2%) abnormalities. Two infants with cyanotic heart disease were operated and four infants with acyanotic heart disease showed improvements without any treatment. Six infants with genitourinary abnormalities on renal ultrasound had mild hydronephrosis without further consequences. CONCLUSION: The incidence of structural abnormalities in the cardiovascular and genitourinary systems is high and the genitourinary anomalies associated with isolated SUA have relatively good prognosis.

A Follow-Up Study of Hematochezia in Neonates and During Early Infancy

PURPOSE: There are many causes of hematochezia in neonates and during early infancy. Cow`s milk allergy is considered to be the most common cause of bloody stools in infants; however, cow`s milk allergy is diagnosed in relatively few patients. In a significant proportion of case investigations, the etiology of hematochezia is not determined. The objectives of this study were to evaluate the clinical course and prognosis of patients with hematochezia of unknown etiology. METHODS: The patients were <4-month-old infants with hematochezia in whom infectious and surgical etiologies had been excluded. We investigate retrospectively the clinical course and laboratory finding. We also perform 2-years follow-up study and evaluate prognosis of the patients. RESULTS: In all study patients, RAST milk was negative. All patients had self-limited hematochezia. In 2-years of follow-up, the prognosis of patients was good. There were no differences at 2-year regarding allergic tendencies of the patients, as determined by the increase in total eosinophil count. CONCLUSION: Hematochezia in neonates and during early infancy is generally a benign and self-limiting symptom. Based on 2-years of follow-up, the prognosis of the patients is good.

A Case of Hypocalcemia due to Vitamin D Deficiency in Exclusively Breast-fed Infant / 대한소아내분비학회지

Hypocalcemia is due to Hypoparathyroidism, Vitamin D deficiency, Hypomagnesemia, Inadequate calcium intake. The benefits of breast-feeding are well established. There are no need to supply calcium or Vitamin D in breast-fed infant. We report a case of infantile hypocalcemia caused by Vitamin D deficiency in exclusively breast-fed infant. He had no hypocalcemic symptom and hypocalcemia was found incidentally by routine laboratory tests during pneumonia treatment. He was presented with a low serum calcium level and 1,25(OH)2 Vit D3 level and high PTH. He was improved by Calcium and Vitamin D supplement. After then his mother continued breast feeding exclusively and resisted to feed her baby weaning food. During follow up period, hypocalcemia was recheked after discontinuation of vitamin D supplement. At 11 months of age, the calcium level was normal without vitamin D supplement after he had eaten weaning food. This report describes a case of hypocalcemia induced by vitamin D deficiency in exclusively breast-fed infant, with review of the literature.