Background: Dioxin affects nervous system via the system of nervous communicative hormones and endocrine hormones, causing disorders and nervous behavior wrongs. Reproductive health is one of the serious effects of exposing Agent Organe/Dioxin. Objectives: To evaluate the birth defects of the nervous system of children, from the generation of veterans exposed to Agent Orange/Dioxin during wartime and to assess congenital nervous defects related factors, characteristics in these subjects. Subject and methods: A retrospective cohort, interview and examine 12.369 exposed and 7.659 unexposed Hanoi veterans, their birth defective children were examined by the pediatrics. During the 2002-2003 timescale. Results: A statistically high significant rate of reproductive failures and birth defects for exposed veterans, compared to unexposed ones, spontaneous abortion with relative risk RR = 4.18, hydatidiform mole with RR = 3.0, still births with RR = 2.2, birth defects with RR = 2.12. Nervous birth defects were highest; representing more than 40% of live births; the relative risk of the exposed group is 2.3 fold higher than the unexposed group, with p < 0.01. The birth defects increased significantly: mild mental retardation with RR = 3.5, severe mental retardation with RR = 3.5, Down's syndrome with RR = 2.16. Conclusions: Nervous birth defects of children of the Hanoi veterans exposed to Agent Orange during wartime accounted for the highest rate. Congenital nervous defects in male were higher than female. Exposed time, exposed levels and direct exposure to Agent Orange were significant related factors in this study. The increase of birth defects was in correlation with exposed levels.
congenital nervous defects ; birth defects ; veterans

Cardiac surgery in the neonate with congenital heart disease has progressed dramatically in the past three decades. However, low-birth-weight premie with congenital heart disease continue to challenge the intellectual and technical skills of those who care for them. We report a case of successful arterial switch operation in 1140 g premie with TGA, IVS after 4 week care 1317 gm.
Heart Defects, Congenital ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Thoracic Surgery ; Transposition of Great Vessels

Cardiac surgery in neonates with congenital heart disease has progressed dramatically in the past three decades. However, low-birth-weight neonates with congenital heart disease continue to challenge the intellectual and technical skills of healthcare professionals. We present a case of a low-birth-weight neonate with pulmonary atresia and a ventricular septal defect, in whom palliation was achieved with a right ventricular outflow tract stent using a hybrid procedure.
Chimera ; Delivery of Health Care ; Heart Diseases ; Heart Septal Defects ; Heart Septal Defects, Ventricular ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Pulmonary Atresia ; Stents ; Thoracic Surgery

OBJECTIVETo analyze the clinical feature of early newborn infants with congenital heart disease.

METHODSWe retrospectively analyzed the clinical features of 477 newborn infants with congenital heart disease born within seven days out of 28 050 live births in Shaoxing women and children hospital from October 1, 2009 to September 30, 2012. Infants with congenital heart disease were divided into single malformation group (240 cases), composite deformity group (199 cases) and multiple malformations group (38 cases). Differences of clinical feature were compared between the three groups.

RESULTSAtrial septal defect was the most malformation 91.6% (437/477) .Incidence of preterm birth was higher in newborn inants with congenital heart disease [512.23/10 000(134/2 616)] than infants without without congenital heart disease [134.86/10 000 (343/25 434) , P < 0.01]. Proportion of preterm birth among the three congenital heart disease groups was similar (P > 0.05) . The incidence of small for gestational age in congenital heart disease group (10.90%, 52/477) was also significantly higher than those without congenital heart disease group (5.91%, 1 630/27 573, P < 0.01).Small for gestational age with congenital heart disease of complex malformations, multiple malformations groups was higher than that in the single malformation group (P < 0.01 and P < 0.05).

CONCLUSIONSEarly newborn with atrial septal defect is the most common neonatal congenital heart disease. The incidence of preterm is higher in newborn infants with congenital heart disease. Complex and multiple malformations are linked with small for gestational age birth weight.

Female ; Heart Defects, Congenital ; diagnosis ; Heart Septal Defects, Atrial ; diagnosis ; Humans ; Infant, Newborn ; Infant, Small for Gestational Age ; Male ; Premature Birth ; Retrospective Studies

PURPOSE: With feasibility in the diagnoses of congenital heart disease (CHD) in the antenatal period, we suspect changes have occurred in its incidence. No data have been reported about the current incidence of simple forms of CHD in Korea. We have attempted to assess the recent incidence and characteristics of CHD in the neonatal care unit of a secondary referral medical center. METHODS: Medical records of 497 neonatal care unit patients who underwent echocardiography in the past 5 years were reviewed. Pre-term infants with patent ductus arteriosus and other transient, minimal lesions were excluded from this study. RESULTS: Although the number of inpatients remained stable, the incidence of simple forms of CHD showed a gradual decrease over the 5-year study period; a markedly low incidence of complex forms was seen as well. CHD was observed in 3.7% full-term and 6.8% pre-term infants. CHD was observed in 152 infants weighing >2,500 g (3.5% of corresponding birth weight infants); 65 weighing 1,000 to 2,500 g (9.3%); and 6 weighing <1,000 g (8.0%). The incidence of CHD was higher in the pre-term group and the low birth weight group than in each corresponding subgroup (P<0.001); however, the incidence of complex CHD in full-term neonates was high. The number of patients with extracardiac structural anomalies has also shown a gradual decrease every year for the past 5 years. CONCLUSION: Findings from our study suggest that the recent incidence and disease pattern of CHD might have changed for both complex and simple forms of CHD in Korea.
Birth Weight ; Ductus Arteriosus, Patent ; Echocardiography ; Heart ; Heart Defects, Congenital ; Heart Diseases ; Humans ; Incidence ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Inpatients ; Korea ; Medical Records ; Referral and Consultation

Although outcomes of neonatal cardiac surgery have dramatically improved in the last two decades, low body weight still constitutes an important risk factor for morbidity and mortality. In particular, cardiac surgery in neonates with very low birth weight (< or =1.5 kg) is carried out with greater risk because most organ systems are immature. We report here on a successful case of early one-stage total repair of coarctation of the aorta and a ventricular septal defect in a 1,480 gram neonate.
Aortic Coarctation ; Body Weight ; Heart Septal Defects, Ventricular ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Very Low Birth Weight ; Risk Factors ; Thoracic Surgery

OBJECTIVETo summarize anesthetic management of low birth weight infants undergoing surgical intervention of congenital heart disease without cardiopulmonary bypass.

METHODSFifty-three low birth weight infants (including 49 premature infants) with congenital heart disease underwent surgical treatment without cardiopulmonary bypass during the period from June, 2003 to July, 2013. The mean gestational age of the infants was 30.96∓3.09 weeks (26-40 weeks) with a mean age on the operation day of 32.81∓20.76 days (4-87 days), birth weight of 1429.90∓455.08 g (640-2460 g), and weight on the operation day of 1750.20∓481.59 g (650-2460 g). All the infants underwent cardiac operations without cardiopulmonary bypass under general anesthesia. The respiratory parameters and acid-base and electrolyte balance were adjusted according to blood gas analysis. The inotropic drug was used to maintain the hemodynamic stability.

RESULTSForty-seven of the infants received patent ductus arteriosus (PDA) ligation. Of these infants, 1 had cardiac arrest before the operation with failed cardiopulmonary resuscitation, and in another case, PDA ligation was aborted due to severe hypoplasia of the aortic valve and ascending aorta found intraoperatively by transesophageal echocardiography. Two infants underwent coarctation of the aorta (CoA), and 1 of them died during the operation due to cardiac arrest. The total mortality of these infants was 3.77% and the early postoperative mortality (<72 h) was 5.66%.

CONCLUSIONSNon-cardiopulmonary bypass surgery can be performed in low birth weight infants in early stage, and effective anesthetic management can reduce the perioperative mortality and improve the postoperative survival rate.

Anesthesia ; methods ; Anesthetics ; Birth Weight ; Cardiac Surgical Procedures ; Cardiopulmonary Bypass ; Gestational Age ; Heart Defects, Congenital ; surgery ; Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Ligation

OBJECTIVE: To analyze the main causes and characteristics for death among children under 5 years old so as to provide the basis for taking strategic measures for child survival, development, protection.
 METHODS: The data of 5 747 dead children, who were under 5 years old in different cities of Hunan Province in 2013, were retrospectively analyzed. Descriptive statistic methods were used to analyze the causes and characteristics of death among the children. Chi-square test was used to analyze the differences of mortality rate.
 RESULTS: In 2013, the under-5 mortality rate (U5MR) was 7.00‰. By linear trend chi-square test, the U5MR from 2002 to 2013 showed a tendency toward decrease (P<0.05). Among the death causes, drowning was the major one and it accounted for 13.35% of death, following by congenital heart disease, premature birth or low birth weight, pneumonia and accidental suffocation, with a ratio at 12.65%, 11.66%, 10.82%, and 8.13%, respectively. After chi-square test, there were differences in U5MR in the cities of Hunan Province in 2013 (χ2=163.185, P<0.05).
 CONCLUSION Compared with previous data, the U5MR in 2013 is decreased significantly. There are differences in U5MR in the cities, and there are also difference in U5MR between city and rural area in Hunan Province in 2013. Among the death causes for children under 5 years old in Hunan Province in 2013, drowning is in the major one, and pneumonia is the fourth one.
Cause of Death ; Child, Preschool ; Female ; Heart Defects, Congenital ; Humans ; Infant ; Infant, Newborn ; Infant, Very Low Birth Weight ; Pneumonia ; Pregnancy ; Premature Birth ; Retrospective Studies

The diagnosis of congenital heart disease includes rare and diverse disorders. Children with congenital heart disease represent a growing population: The incidence of congenital heart defects is almost 1 in 100 live births, and of these, approximately 23 of 1000 newborns will require invasive treatment or will die as a consequence of their diagnosis by 1 year of age. Because of improved interventions, >1 million adults are now living with congenital heart disease. Selected congenital heart defects (or the process of their repair) lead to an increased risk for adult cardiovascular disease compared with the general population. Now we reviewed the methods of assessment for differential diagnosis of congenital heart diseases.
Adult ; Cardiovascular Diseases ; Child ; Diagnosis ; Diagnosis, Differential* ; Heart Defects, Congenital ; Heart Diseases* ; Heart* ; Humans ; Incidence ; Infant, Newborn ; Live Birth

PURPOSE: Intrauterine growth retardatation(IUGR) is very important because of high mortality and morbidity in the neonatal period. We studied the intrauterine growth retardation pattern in neonates with congenital heart disease(CHD). METHODS: One hundred seventeen cases with CHD(acyanotic, 73 cases; cyanotic, 44 cases) who had no other congenital malformation or maternal diseases that might affect fetal growth were enrolled in this study along with 120 control cases without CHD. We analyzed birth weight, crown-heel length and neonatal ponderal index. RESULTS:The proportion of IUGR infants was 17 out of 237 cases(7.2%). Compared to a normal control group(5/120, 4.2%), the CHD group had more IUGR(12/117, 10.3%)(P=0.006). Low birth weight(LBW) was higher in the CHD group(26/117, 22.2% vs 15/120, 12.5%; P=0.048). Among the CHD group, acyanotic CHD had often more than cyanotic CHD(21/73, 28.8% vs 5/44, 11.4%; P= 0.028). The proportion of IUGR among the LBW was 12 out of 41 cases(16.3%) in total. But, there were no significant difference in the proportion of IUGR among the LBW(10/26, 38.5% vs 2/15, 13.3 %; P=0.089), the proportion of IUGR among the prematurity(3/25, 12.0% vs 2/25, 8.0%; P=0.637) and abnormal neonatal ponderal index(5/12, vs 3/5; P=0.490). The proportion of short crown-heel length was high in the CHD group(7/117, 6.0% vs 1/120, 0.8%; P=0.028). CONCLUSION: Neonates with CHD had greater incidence of LBW, short crown-heel length and IUGR compared to normal neonates. Moreover, symmetrical IUGR was more common in IUGR neonates with CHD. Therefore, intrauterine development might be more influenced by intrinsic fetal factors than hemodynamic alteration of the circulation in CHD with IUGR.
Birth Weight ; Fetal Development ; Fetal Growth Retardation ; Heart ; Heart Defects, Congenital* ; Hemodynamics ; Humans ; Incidence ; Infant ; Infant, Newborn* ; Mortality ; Parturition