PURPOSE: This study aimed to evaluate serum 25-hydroxyvitamin D [25(OH)D3] levels of full-term neonates in Daegu and Gyeongbuk province of Korea to determine the association between maternal and neonatal diseases, known to be affected by low 25(OH)D3 levels. METHODS: Serum 25(OH)D3 levels were evaluated in full-term neonates (n=122) who were born at Kyungpook National University Hospital. Normal full-term neonates (control group, n=38) were classified by sex, season of birth, and delivery mode (normal or caesarean section). Serum 25(OH)D3 levels in neonates (n=84) with maternal diseases (gestational diabetes mellitus, hypothyroidism, pregnancy induced hypertension, premature rupture of membrane and systemic lupus erythematosus) and neonatal diseases (small for gestational age, transient tachypnea of newborn and pneumonia) were compared with those in control group. RESULTS: The mean serum 25(OH)D3 level in the control group was 9.2+/-5.0 ng/mL. There were no statistically significant differences of serum 25(OH)D3 level between the control group and the disease group. In the control group, 63.2% of serum 25(OH)D3 levels referred to vitamin D deficiency, and 34.2% referred to vitamin D insufficiency. In the maternal disease group and the neonatal disease group, 56.1% and 63.0% of serum 25(OH)D3 levels referred to vitamin D deficiency, and 35.0% and 33.3% referred to vitamin D insufficiency. CONCLUSION: High percentages of neonates were found to be deficient or insufficient in vitamin D. Although low 25(OH)D3 levels have previously been associated with maternal and infant diseases, the association was not observed in this study.
Daegu* ; Diabetes Mellitus ; Female ; Gestational Age ; Gyeongsangbuk-do* ; Humans ; Hypertension, Pregnancy-Induced ; Hypothyroidism ; Infant ; Infant, Newborn* ; Korea* ; Membranes ; Parturition ; Pregnancy ; Rupture ; Seasons ; Transient Tachypnea of the Newborn ; Vitamin D Deficiency ; Vitamin D* ; Vitamins*

PURPOSE: Corticosteroids has been used for treatment and prophylaxis of bronchopulmonary dysplasia (BPD) in preterm infants. However, administration of corticosteroids could be delayed due to its potential harmful effects on neurodevelopment. The aim of this study was to evaluate the adequate dexamethasone administration timing in very low birth weight infants. METHODS: Medical records of 56 VLBW infants who were admitted to neonatal intensive care unit of Seoul National University Children's Hospital and Seoul National University Bundang Hospital between January 2008 and September 2014 were collected retrospectively. Study population were divided into early administration group (dexamethasone administration before 4 weeks of postnatal days) and late administration group (after 4 weeks) and respiratory morbidities were compared between groups. RESULTS: There were no significant differences in clinical characteristics between early administration group (n=30) and late administration group (n=26). Respiratory severity score and oxygen needs at 7 days after birth and before administering dexamethasone were comparable. Extubation was done earlier postnatal days in early administration group. Incidence of severe BPD was higher in the late administration group. There was no significant difference in diagnosed with cerebral palsy (CP) at 12 months of corrected age. When adjusting for multiple risk factors, administration of dexamethasone 4 weeks after birth and severe of BPD showed a significant association (adjusted OR 17.14 [1.29-227.52], P=0.031). CONCLUSION: Administration of dexamethasone in order to minimize ventilator care and to reduce severe BPD might be done between 1 week and 4 weeks after birth in very low birth weight infants.
Adrenal Cortex Hormones ; Bronchopulmonary Dysplasia* ; Cerebral Palsy ; Dexamethasone* ; Humans ; Incidence ; Infant* ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight* ; Intensive Care, Neonatal ; Medical Records ; Oxygen ; Parturition ; Retrospective Studies ; Risk Factors ; Seoul ; Ventilators, Mechanical

PURPOSE: This study aimed to identify the risk factors of persistent pulmonary hypertension of the newborn (PPHN) in neonates with respiratory diseases. METHODS: We retrospectively analyzed 58 term newborn infants with respiratory diseases who were admitted to the neonatal intensive care unit of the Seoul Eulji Hospital between January 2008 and July 2014 and required airway intubation and mechanical ventilation within 24 hours of admission. The infants were divided into a PPHN group and a non-PPHN group. Their clinical characteristics; diagnoses at admission; initial blood test results; and changes in vital signs, blood gas analysis results, and ventilator parameters that occurred within 48 hours of admission were investigated. RESULTS: There were 16 infants in the PPHN group and 42 infants in the non-PPHN group. The incidence of secondary PPHN was 27.6%. The incidence of PPHN was significantly higher in infants with respiratory distress syndrome (RDS) associated with extrapulmonary air leakage and meconium aspiration syndrome (MAS) with secondary RDS as the cause. Respiratory rate over 80 breaths/min (P=0.032, OR 11.3, 95%, CI 1.23-103.57) and FiO2 over 0.8 (P=0.013, OR 16.8, 95% CI 1.82-154.68), when measured 6 hours after admission, were found to be statistically significant risk factors. CONCLUSION: The results suggest that there is an increased risk of PPHN during treatment of respiratory diseases when aggravation of tachypnea and increase in ventilator parameters are observed after 6 hours of admission.
Blood Gas Analysis ; Diagnosis ; Hematologic Tests ; Humans ; Hypertension, Pulmonary* ; Incidence ; Infant ; Infant, Newborn* ; Intensive Care, Neonatal ; Intubation ; Meconium Aspiration Syndrome ; Respiration, Artificial ; Respiratory Rate ; Retrospective Studies ; Risk Factors* ; Seoul ; Tachypnea ; Ventilators, Mechanical ; Vital Signs

PURPOSE: This study aimed to identify the safety of Kangaroo Mother Care (KMC) and to analyze its medical and psychological effects. METHODS: Forty five preterm infants, admitted to Gangnam Severance Hospital NICU from October 2012 to September 2013, were recruited. KMC was performed for 1 hour daily until the discharge by either mother or father. The medical effects in KMC group were compared with historical control group. Psychological effects in KMC group were made a comparison with the non-KMC group. RESULTS: The mean gestational age was 31.3+/-3.5 weeks, and the mean birth weight was 1,080+/-250 g. KMC was started at the mean age of 18.3+/-8.4 days. No event of hypothermia, bradycardia, desaturation, or hypotension occurred. There was no event of death or sepsis. Four patients (9%) had apnea but recovered after the tactile stimulation. Duration of the hospitalization in KMC group was significantly shorter than control group (P=0.041). Spielberger's anxiety scale decreased from 49.7 to 48.5. Muller's maternal attachment inventory increased from 98.4 to 99.5. Reduction of the self-happiness score improved from 5% to 70%. The score for Spielberger's anxiety scale tended to be lower in the KMC group than in the control group without statistically significant. Muller's maternal attachment inventory score was significantly higher in the KMC group. CONCLUSION: KMC is a safe method to Korean preterm infants. Due to reduction of hospitalization and beneficial psychological effect, we believe that offering KMC to more preterm infants as a supplement therapy will be useful.
Anxiety ; Apnea ; Birth Weight ; Bradycardia ; Fathers ; Gestational Age ; Hospitalization ; Humans ; Hypotension ; Hypothermia ; Infant, Newborn ; Infant, Premature* ; Kangaroo-Mother Care Method* ; Korea* ; Macropodidae* ; Mothers ; Sepsis

PURPOSE: To study the causative microorganism of neonatal bacterial conjunctivitis and its correlation with maternal factors. METHODS: We retrospectively reviewed the medical records of 55 neonates diagnosed with bacterial conjunctivitis and the records of mothers from January 2008 to July 2013. We investigated microbiologic culture of conjunctival discharge, time of occurrence, the mode of delivery, premature rupture of membrane (PROM), microbiologic culture of vaginal swab and the sensitivities to antibiotics. RESULTS: The most common organism was Staphylococcus epidermidis, isolated in 24 (36.4%) neonates, followed by other Coagulase-negative Staphylococcus (CNS) 10 (15.2%), E. cloacae 6 (9.1%), S. marsescens 6 (9.1%), and P. aeruginosa 5 (7.6%). Concerning the time of occurrence, 23 (41.8%) were founded with conjunctivitis within 1 week of life. By mode of delivery, 18 (32.7%) were delivered through vaginal route and 37 (67.3%) delivered by Cesarean section. The most common organism grown in conjunctival discharge of both group was S. epidermidis. Of these 55 neonates' mothers, 9 (16.4%) had history of PROM. Regardless of the presence of PROM, the most common organism was S. epidermidis. A total of 22 (40.0%) microbiologic culture of vaginal swab were examined and 6 (27.2%) of them had detected organisms. The results of vaginal swabs were in discord with results of conjunctival swabs of neonates. CONCLUSION: S. epidermidis was the most common infectious organism of neonatal bacterial conjunctivitis. We could not identify the correlation between neonatal bacterial conjunctivitis and maternal factors. Further comprehensive studies are needed to investigate the risk factors related to bacterial conjunctivitis of neonates.
Anti-Bacterial Agents ; Cesarean Section ; Cloaca ; Conjunctivitis ; Conjunctivitis, Bacterial* ; Female ; Humans ; Infant, Newborn ; Medical Records ; Membranes ; Mothers ; Pregnancy ; Retrospective Studies ; Risk Factors ; Rupture ; Staphylococcus ; Staphylococcus epidermidis

For many years preterm infants with respiratory distress syndrome have been managed with a combination of intubation and surfactant replacement therapy. It is now recognized that applying noninvasive ventilation (NIV) such as nasal continuous positive airway pressure (CPAP) in preterm infants is a reasonable alternative to early intubation after birth. Recently, nasal CPAP has shown a benefit with a small reduction in the risk of the combined outcome of death or bronchopulmonary dysplasia. There has been an upsurge in the use of NIV as primary therapy for preterm infants, bringing with it the dilemma of when and how to give exogenous surfactant. In an effort to overcome this problem, minimally invasive surfactant therapy (MIST) to spontaneously breathing infants, allows them to remain on CPAP in first days after birth. MIST has included administration of exogenous surfactant by brief tracheal catheterization, aerosolization, laryngeal mask, and intrapharyngeal instillation. In recent clinical trials, surfactant delivery via brief tracheal catheterization was found to reduce the need for subsequent intubation and mechanical ventilation and to improve short-term respiratory outcomes. In conclusion, MIST is gentle, safe, feasible and effective to perform in preterm infants and will also be used commonly in Korea.
Bronchopulmonary Dysplasia ; Catheterization ; Catheters ; Continuous Positive Airway Pressure ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Intubation ; Korea ; Laryngeal Masks ; Noninvasive Ventilation ; Parturition ; Respiration ; Respiration, Artificial

AEC syndrome (Ankyloblepharon-Ectodermal defects-Cleft lip/palate syndrome) is a rare disorder characterized by ankyloblepharon, ectodermal dysplasia and cleft lip or palate. This disease is inherited in an autosomal dominant pattern with variable expressivity, and mutations in the TP63 gene on chromosome 3q28 are the genetic basis. A 14-day-old Korean boy presented with coarse, sparse hair on his scalp, erosive dermatitis, nail dysplasia, and a cleft palate at birth. Direct sequence analysis of the entire coding region of the TP63 gene of this boy showed a missense mutation c.1739 C>T (p.Ser541Phe) in the sterile-alpha-motif (SAM) domain. Family study revealed that neither of the parents had the mutation, indicating the de novo occurrence of the mutation. This is the second Korean case report of a genetically confirmed as AEC syndrome.
Cleft Lip ; Cleft Palate ; Clinical Coding ; Dermatitis ; Ectodermal Dysplasia ; Eye Abnormalities ; Eyelids ; Hair ; Humans ; Infant, Newborn ; Mutation, Missense ; Nails ; Palate ; Parents ; Parturition ; Scalp ; Sequence Analysis

Hemangiopericytoma is a rare vascular tumor that usually occurs in adults. The tumor is believed to originate from pericytes that are closely related to the capillary walls. Congenital hemangiopericytoma is a more rare disease that occurs in approximately 0.03% of all heamngiopericytomas. Herein, we describe a 1-month-old male newborn with huge congenital hemangiopericytoma in the retroperitoneum that exhibited a typical morphological vascular pattern.
Adult ; Capillaries ; Hemangiopericytoma ; Humans ; Infant, Newborn ; Male ; Pericytes ; Rare Diseases

Haddad syndrome is an extremely rare disorder which combines congenital central hypoventilation syndrome (CCHS) and Hirschsprung's disease. Several reports have demonstrated that CCHS was related to mutation of the PHOX2B gene. We report here a newborn male infant with apnea and bowel obstruction. He has been diagnosed with combined congenital central hypoventilation syndrome and Hirschsprung's disease, and had 27 polyalanine repeats in the PHOX2B gene. Two cases of Haddad syndrome with identified PHOX2B gene mutation have been recently reported in Korea. Both of them had extended alleles containing 26 polyalanine repeats. It is known that increased number of polyalanine repeat mutations is associated with a more severe clinical phenotype. The baby reported here had 27 alanine repeats (i.e. one more than the previously reported cases in Korea) and ganglion cells could be found only in the distal 70 cm of his small bowel.
Alanine ; Alleles ; Apnea ; Ganglion Cysts ; Hirschsprung Disease ; Humans ; Hypoventilation ; Infant ; Infant, Newborn ; Korea ; Male ; Peptides ; Phenotype ; Short Bowel Syndrome ; Sleep Apnea, Central

Thrombosis of the dural sinus in the fetal period is an extremely rare congenital cerebrovascular condition. The exact etiologies and prognosis of dural sinus thrombosis in the fetal period are still unknown due to the extremely limited clinical information available. Therefore, we present a case of dural sinus thrombosis diagnosed by prenatal ultrasound and fetal magnetic resonance imaging that spontaneously regressed, with a brief review of the relevant literature.
Magnetic Resonance Imaging ; Prenatal Diagnosis ; Prognosis ; Sinus Thrombosis, Intracranial ; Thrombosis