Catch-up growth and development of very low birth weight infants / 소아과

PURPOSE: The aim of this study was to analyze the results and contributing factors of catch-up growth in very low birth weight infants(VLBWI) at the corrected age of 2 years. In addition, we looked for a relationship between the catch-up growth and the development by the bayley scales of infant development II(BSID II). METHODS: A retrospective analysis by evaluating medical records was done for the 76 VLBWI whose follow-up was possible up to a corrected age of 2 years, out of the 114 who had been treated in the neonatal intensive care unit during the January of 2000 to December of 2001 at Samsung Cheil Hospital. Based on the Standard Korean Infant's Growth Curve, the catch-up growth group was defined over the 10th percentile of weight at 2 years as the corrected age and the failed catch-up growth group was defined under the 10th percentile. We investigated the clinical factors and courses of each group and compared the scores of the BSID II. RESULTS: The catch-up growth group of the VLBWI was 51 infants and the failed catch-up growth group was 25 infants. In comparison with maternal clinical factors, use of antenatal steroids was significantly higher in the catch-up growth group. In comparisn with clinical factors and courses of VLBWI, two clinical factors were significantly different between the two groups: birth weight and intrauterine growth retardation(IUGR). Numbers of delayed development were increased in the failed catch-up growth group but statistically significant differences could not be observed. CONCLUSION: The catch-up growth of the VLBWI was affected by the use of antenatal steroids, birth weight and IUGR. No significant differences regarding neurodevelopmental outcome were observed between the catch-up and failed catch-up growth groups.

A Symptom-free Congenital Sliding Hiatal Hernia Diagnosed within 24 Hours after Birth

The classification of hiatal hernia is made by the position of the gastroesophageal junction. Although sliding hiatal hernia (type 1) is the most common type of hiatal hernia, it is very uncommon to be found in early infancy because it is usually symptom free. We report a case of type 1 hiatal hernia of newborn infant who had diagnosed by simple chest radiography taken because of transient tachypnea of the newborn.

Outcome of Surviving Twins with Antenatal Death of the Co-Twin: Comparison with Normal Twins

PURPOSE: In twin pregnancies with single fetal death after 20th weeks, the surviving co-twin has an ischemic change of multiple organ, neurological abnormality, high perinatal morbidity and mortality. The purpose of this study was to evaluate the clinical status and the outcome of live co-twins and to compare them with the normal viable twins. METHODS: A retrospective analysis by evaluating medical records was done for those twin pregnancies with single fetal demise after 20 weeks (n=20) during January 2000 to June 2003 at Samsung Cheil Hospital. Normal viable twins (n=847) born during the same study period were used as a control group. RESULTS: 867 of 31, 219 live deliveries were documented as twin births. 20 twin pregnancies were complicated by the death of one fetus after 20th weeks. In these 20 twin pregnancies, two surviving co-twins died after birth. There was an increased incidence of monochorionic placenta, prematurity, VLBW (very low birth weight), admission rate in neonate and mortality among the surviving co-twins as compared to the normal viable twins (P<0.001). However, there was no significant difference between surviving co- twins with dichorionic placenta and normal viable twins. CONCLUSION: The perinatal morbidity and mortality of surviving twins were higher than the normal twins in the monochorionic twins whose co-twin's death occurred after 20th weeks suggests that chorionicity of placenta might be an important factor to predict the outcome of surviving co-twin's.

Outcome of Very Low Birth Weight Infants in Past 2 Years at Samsung Cheil Hospital

PURPOSE: As the neonatal intensive care advanced, the survival rate of the very low birth weight infant (VLBWI) has steadily increased. We evaluated the outcome of VLBWIs who were born at Samsung Cheil Hospital. METHODS: A retrospective review was conducted for survival, morbidities and developmental outcome on 114 VLBWIs out of total 17, 720 newborn infants who were born between January 1st, 2000 and December 31st, 2001. RESULTS: The incidence of VLBWI was 0.6%. Overall survival rate of VLBWI was 92.1%. All the Infants less than 500 g died, but the survival rate increased as birth weight increased. The survival rate was 75% for infants 500 g to 749 g, 85% for those 750 g to 999 g, 93.3% for those 1, 000 g to 1, 249 g, 98.1% for those 1, 250 g to 1, 499 g. The survival rates by gestational age also increased from 0 in those of 23-24 weeks to 80% in 25-26 weeks, 87.0% in 27-28 weeks, and up to 98.7% in those 29 weeks or more. Common morbidities in VLBWIs included respiratory distress syndrome (43.9%), bronchopulmonary dysplasia (21.9%), retinopathy of prematurity (> or = stage II+, 12.3%), necrotizing enterocolitis (7%), intraventricular hemorrhage (> or =grade III, 4.4%) in the order of frequency. Bayley Scales of Infant Development II (BSID II) were performed on 38 VLBWIs. 9 (23.7%) of those tested showed delayed development, and 4 (10.5%) of whom were significantly delayed. CONCLUSION: 92.1% of VLBWIs survived. Survival rates increased as birth weight and gestational age increased. More efforts are needed to improve the long term outcome by reducing common morbidities.