1.Growth and Developmental Outcomes of Triplets Preterm Infants according to the Chorionicity: A Retrospective Cohort Study
Eun Woo NAM ; Jae Hui RYU ; Hye Su HWANG ; Ho Jung CHOI ; Seulgi PARK ; Seung Han SHIN ; Ee-Kyung KIM ; Han-Suk KIM
Perinatology 2024;35(2):61-68
Objective:
We elucidated the effect of monochorionicity on neonatal and long-term neurologic outcomes on an individual basis in triplets.
Methods:
We retrospectively reviewed the perinatal outcomes and development and growth at 18 to 24 months corrected age (CA) of triplets born alive between 24 and 32 weeks of gestational age (GA) between 2009 and 2021 from the Seoul National University Hospital database. Neurodevelopmental impairment (NDI) was defined as any delay among the Bayley-III domains (motor and language), cerebral palsy, hearing impairment, or visual loss and was performed at a CA of 18 to 24 months.
Results:
We included 40 sets of triplets (120 infants), comprising 26, 10, and 4 sets of trichorionic (TC), dichorionic (DC), and monochorionic (MC) triplets, respectively. Ten infants, unaffected by monochorionicity out of 30 DC infants, were included in the non-MC group. Eighty-eight infants were included in the non-MC group, and 32 infants were affected by monochorionicity. In vitro fertilization-embryo transfer was more frequent in the non-MC group (P<0.05), and twin-to-twin transfusion syndrome affected only the MC group (P<0.01). At 24 months of CA, a combined delay of language and cognition in Bayley-III was evident in the MC group (P<0.05). Although NDI did not significantly differ between the 2 groups (P=0.059), the composite outcome of NDI+ postnatal death was significantly different (P<0.05). NDI+ postnatal death correlated with GA, Z-score of birth weight, brain injury, and monochorionicity in the univariate analysis (P<0.05). Multivariate analysis revealed a significant correlation between monochorionicity and NDI+ postnatal death. (P<0.05).
Conclusion
Monochorionicity is associated with adverse long-term neurodevelopmental out comes.
2.Growth and Developmental Outcomes of Triplets Preterm Infants according to the Chorionicity: A Retrospective Cohort Study
Eun Woo NAM ; Jae Hui RYU ; Hye Su HWANG ; Ho Jung CHOI ; Seulgi PARK ; Seung Han SHIN ; Ee-Kyung KIM ; Han-Suk KIM
Perinatology 2024;35(2):61-68
Objective:
We elucidated the effect of monochorionicity on neonatal and long-term neurologic outcomes on an individual basis in triplets.
Methods:
We retrospectively reviewed the perinatal outcomes and development and growth at 18 to 24 months corrected age (CA) of triplets born alive between 24 and 32 weeks of gestational age (GA) between 2009 and 2021 from the Seoul National University Hospital database. Neurodevelopmental impairment (NDI) was defined as any delay among the Bayley-III domains (motor and language), cerebral palsy, hearing impairment, or visual loss and was performed at a CA of 18 to 24 months.
Results:
We included 40 sets of triplets (120 infants), comprising 26, 10, and 4 sets of trichorionic (TC), dichorionic (DC), and monochorionic (MC) triplets, respectively. Ten infants, unaffected by monochorionicity out of 30 DC infants, were included in the non-MC group. Eighty-eight infants were included in the non-MC group, and 32 infants were affected by monochorionicity. In vitro fertilization-embryo transfer was more frequent in the non-MC group (P<0.05), and twin-to-twin transfusion syndrome affected only the MC group (P<0.01). At 24 months of CA, a combined delay of language and cognition in Bayley-III was evident in the MC group (P<0.05). Although NDI did not significantly differ between the 2 groups (P=0.059), the composite outcome of NDI+ postnatal death was significantly different (P<0.05). NDI+ postnatal death correlated with GA, Z-score of birth weight, brain injury, and monochorionicity in the univariate analysis (P<0.05). Multivariate analysis revealed a significant correlation between monochorionicity and NDI+ postnatal death. (P<0.05).
Conclusion
Monochorionicity is associated with adverse long-term neurodevelopmental out comes.
3.Growth and Developmental Outcomes of Triplets Preterm Infants according to the Chorionicity: A Retrospective Cohort Study
Eun Woo NAM ; Jae Hui RYU ; Hye Su HWANG ; Ho Jung CHOI ; Seulgi PARK ; Seung Han SHIN ; Ee-Kyung KIM ; Han-Suk KIM
Perinatology 2024;35(2):61-68
Objective:
We elucidated the effect of monochorionicity on neonatal and long-term neurologic outcomes on an individual basis in triplets.
Methods:
We retrospectively reviewed the perinatal outcomes and development and growth at 18 to 24 months corrected age (CA) of triplets born alive between 24 and 32 weeks of gestational age (GA) between 2009 and 2021 from the Seoul National University Hospital database. Neurodevelopmental impairment (NDI) was defined as any delay among the Bayley-III domains (motor and language), cerebral palsy, hearing impairment, or visual loss and was performed at a CA of 18 to 24 months.
Results:
We included 40 sets of triplets (120 infants), comprising 26, 10, and 4 sets of trichorionic (TC), dichorionic (DC), and monochorionic (MC) triplets, respectively. Ten infants, unaffected by monochorionicity out of 30 DC infants, were included in the non-MC group. Eighty-eight infants were included in the non-MC group, and 32 infants were affected by monochorionicity. In vitro fertilization-embryo transfer was more frequent in the non-MC group (P<0.05), and twin-to-twin transfusion syndrome affected only the MC group (P<0.01). At 24 months of CA, a combined delay of language and cognition in Bayley-III was evident in the MC group (P<0.05). Although NDI did not significantly differ between the 2 groups (P=0.059), the composite outcome of NDI+ postnatal death was significantly different (P<0.05). NDI+ postnatal death correlated with GA, Z-score of birth weight, brain injury, and monochorionicity in the univariate analysis (P<0.05). Multivariate analysis revealed a significant correlation between monochorionicity and NDI+ postnatal death. (P<0.05).
Conclusion
Monochorionicity is associated with adverse long-term neurodevelopmental out comes.
4.Growth and Developmental Outcomes of Triplets Preterm Infants according to the Chorionicity: A Retrospective Cohort Study
Eun Woo NAM ; Jae Hui RYU ; Hye Su HWANG ; Ho Jung CHOI ; Seulgi PARK ; Seung Han SHIN ; Ee-Kyung KIM ; Han-Suk KIM
Perinatology 2024;35(2):61-68
Objective:
We elucidated the effect of monochorionicity on neonatal and long-term neurologic outcomes on an individual basis in triplets.
Methods:
We retrospectively reviewed the perinatal outcomes and development and growth at 18 to 24 months corrected age (CA) of triplets born alive between 24 and 32 weeks of gestational age (GA) between 2009 and 2021 from the Seoul National University Hospital database. Neurodevelopmental impairment (NDI) was defined as any delay among the Bayley-III domains (motor and language), cerebral palsy, hearing impairment, or visual loss and was performed at a CA of 18 to 24 months.
Results:
We included 40 sets of triplets (120 infants), comprising 26, 10, and 4 sets of trichorionic (TC), dichorionic (DC), and monochorionic (MC) triplets, respectively. Ten infants, unaffected by monochorionicity out of 30 DC infants, were included in the non-MC group. Eighty-eight infants were included in the non-MC group, and 32 infants were affected by monochorionicity. In vitro fertilization-embryo transfer was more frequent in the non-MC group (P<0.05), and twin-to-twin transfusion syndrome affected only the MC group (P<0.01). At 24 months of CA, a combined delay of language and cognition in Bayley-III was evident in the MC group (P<0.05). Although NDI did not significantly differ between the 2 groups (P=0.059), the composite outcome of NDI+ postnatal death was significantly different (P<0.05). NDI+ postnatal death correlated with GA, Z-score of birth weight, brain injury, and monochorionicity in the univariate analysis (P<0.05). Multivariate analysis revealed a significant correlation between monochorionicity and NDI+ postnatal death. (P<0.05).
Conclusion
Monochorionicity is associated with adverse long-term neurodevelopmental out comes.
5.Growth and Developmental Outcomes of Triplets Preterm Infants according to the Chorionicity: A Retrospective Cohort Study
Eun Woo NAM ; Jae Hui RYU ; Hye Su HWANG ; Ho Jung CHOI ; Seulgi PARK ; Seung Han SHIN ; Ee-Kyung KIM ; Han-Suk KIM
Perinatology 2024;35(2):61-68
Objective:
We elucidated the effect of monochorionicity on neonatal and long-term neurologic outcomes on an individual basis in triplets.
Methods:
We retrospectively reviewed the perinatal outcomes and development and growth at 18 to 24 months corrected age (CA) of triplets born alive between 24 and 32 weeks of gestational age (GA) between 2009 and 2021 from the Seoul National University Hospital database. Neurodevelopmental impairment (NDI) was defined as any delay among the Bayley-III domains (motor and language), cerebral palsy, hearing impairment, or visual loss and was performed at a CA of 18 to 24 months.
Results:
We included 40 sets of triplets (120 infants), comprising 26, 10, and 4 sets of trichorionic (TC), dichorionic (DC), and monochorionic (MC) triplets, respectively. Ten infants, unaffected by monochorionicity out of 30 DC infants, were included in the non-MC group. Eighty-eight infants were included in the non-MC group, and 32 infants were affected by monochorionicity. In vitro fertilization-embryo transfer was more frequent in the non-MC group (P<0.05), and twin-to-twin transfusion syndrome affected only the MC group (P<0.01). At 24 months of CA, a combined delay of language and cognition in Bayley-III was evident in the MC group (P<0.05). Although NDI did not significantly differ between the 2 groups (P=0.059), the composite outcome of NDI+ postnatal death was significantly different (P<0.05). NDI+ postnatal death correlated with GA, Z-score of birth weight, brain injury, and monochorionicity in the univariate analysis (P<0.05). Multivariate analysis revealed a significant correlation between monochorionicity and NDI+ postnatal death. (P<0.05).
Conclusion
Monochorionicity is associated with adverse long-term neurodevelopmental out comes.
6.Study on the Perception and Need of Tele-physical Therapy for People in 50s and Older in Korea
In Seon JUNG ; Jin Ee KIM ; Kyeong Min KIM ; Jun Young PARK ; Seung Wook SON ; Chan Yeon LEE ; Hee Jae LEE ; Minhee KIM
Journal of Korean Physical Therapy 2023;35(1):1-7
Purpose:
This study sought to investigate the perceptions and service needs of tele-physical therapy among people in their 50s and older in Korea.
Methods:
Subjects were inducted during a 14-day survey of 104 people over the age of 50 in Korea and were administered a questionnaire consisting of 14 questions about their general characteristics and another 14 questions about tele-physical therapy.
Results:
The general characteristics of the participants (participants’ gender, whether they were single or married, number of cohabiting families, final education, major, job, physical therapy experience, tele-physical therapy experience, presence of a physical therapy worker among relatives, subjective health awareness, chronic disease conditions if any, frequency of drinking, and smoking) were investigated.Among the perceptions of the subjects about tele-physical therapy, the score of ‘awareness’ was the lowest, and that of ‘resolving restrictions on hospital visits’ was the highest. In an analysis of the correlation between perceptions and needs, there was a significant correlation with factors other than ‘awareness’ and ‘information protection’ factors. The regression analysis of necessity and factors revealed that the awareness of necessity increased as the intention to use, health improvement, and time efficiency improved.
Conclusion
These findings presented the perception and necessity of tele-physical therapy for adults in their 50s or older in Korea. These results will help confirm the demand for tele-physical therapy in this age group in Korea and the need to improve the available physical therapy services.
7.A Korean Child with Schaaf-Yang Syndrome Presented with Hearing Impairment: A Case Report
Seung Hoon LEE ; Seung Han SHIN ; Jung Min KO ; Boram KIM ; Hyeon Sae OH ; Man Jin KIM ; Seul Gi PARK ; Ee-Kyung KIM ; Han-Suk KIM
Neonatal Medicine 2022;29(3):112-116
Schaaf-Yang syndrome (SYS) is a rare genomic imprinting disorder caused by truncating mutations in the paternally derived MAGE family member L2 (MAGEL2) allele. It is also responsible for Prader-Willi syndrome, characterized by neonatal hypotonia, developmental delay, intellectual disability, respiratory distress in early infancy, and arthrogryposis. More than 250 individuals with approximately 57 different molecular variants have been reported since 2013, but the phenotype-genotype association in SYS is not yet fully understood. Here, we describe the case of a Korean patient diagnosed with SYS harboring a mutation in the paternal allele of MAGEL2: c.2895G>A, resulting in a protein change of p.Trp965*. The patient’s phenotype included respiratory distress, arthrogryposis, hypotonia, and feeding difficulty in the early neonatal period. Mild renal dysfunction and hearing impairment were observed during infancy.
8.Cognitive and Behavioral Outcomes of School-aged Children Born Extremely Preterm: a Korean Single-center Study with Long-term Follow-up
Eun Sun KIM ; Ee-Kyung KIM ; Sae Yun KIM ; In Gyu SONG ; Young Hwa JUNG ; Seung Han SHIN ; Han-Suk KIM ; Johanna Inhyang KIM ; Bung Nyun KIM ; Min-Sup SHIN
Journal of Korean Medical Science 2021;36(39):e260-
Background:
School-aged children born very preterm have been suggested to have worse cognitive and behavioral outcomes than children born full-term. Executive function (EF) is a higher level of cognitive function related to academic achievement. The present study aimed to evaluate the cognitive (including EF) and behavioral outcomes of Korean children born extremely preterm (EP) and to analyze any biological or socioeconomic risk factors for poor cognitive outcomes in this population.
Methods:
A total of 71 infants weighing < 1,000 g at birth or born before 30 weeks of gestation (EP group) who were admitted to the neonatal intensive care unit from 2008 to 2009 were included in this study and compared with 40 term-birth controls. The Korean Wechsler Intelligence Scale for Children-Fourth Edition, Advanced Test of Attention (ATA), Stroop test, Children's Color Trails Test (CCTT), and Wisconsin Card Sorting Test (WCST) were used.Additionally, the Korean Child Behavior Checklist (K-CBCL) and Korean ADHD Rating Scale (K-ARS) were completed. Perinatal and demographic data were collected and analyzed.
Results:
The mean full-scale intelligence quotient (FSIQ) score in the EP group was significantly lower than that of the term control group (89.1 ± 18.3 vs. 107.1 ± 12.7; P < 0.001).In the EP group, 26 (37%) children had an FSIQ score below 85, compared to only one child (3%) in the control group. Furthermore, the EP group showed significantly worse EF test results (ATA, Stroop test, CCTT, WCST). Except for the higher social immaturity subscore in the EP group, the K-CBCL and K-ARS scores were not different between the two groups. EP children who received laser treatment for retinopathy of prematurity (ROP) had an 8.8-fold increased risk of a low FSIQ score, and a 1-point increase in the discharge weight Z-score decreased the risk of a low FSIQ score by approximately half in this EP cohort.
Conclusion
This is the first Korean study to investigate the cognitive and behavioral outcomes of school-aged children born EP. In the study cohort, EP children exhibited significantly lower FSIQ scores and EF than their full-term peers, and 37% of them had cognitive problems. Nonetheless, except for social immaturity, the behavioral problems werenot different in EP children. Severe ROP and low discharge weight Z-score were identified as independent risk factors for low FSIQ score after adjusting for birth weight.
9.Cognitive and Behavioral Outcomes of School-aged Children Born Extremely Preterm: a Korean Single-center Study with Long-term Follow-up
Eun Sun KIM ; Ee-Kyung KIM ; Sae Yun KIM ; In Gyu SONG ; Young Hwa JUNG ; Seung Han SHIN ; Han-Suk KIM ; Johanna Inhyang KIM ; Bung Nyun KIM ; Min-Sup SHIN
Journal of Korean Medical Science 2021;36(39):e260-
Background:
School-aged children born very preterm have been suggested to have worse cognitive and behavioral outcomes than children born full-term. Executive function (EF) is a higher level of cognitive function related to academic achievement. The present study aimed to evaluate the cognitive (including EF) and behavioral outcomes of Korean children born extremely preterm (EP) and to analyze any biological or socioeconomic risk factors for poor cognitive outcomes in this population.
Methods:
A total of 71 infants weighing < 1,000 g at birth or born before 30 weeks of gestation (EP group) who were admitted to the neonatal intensive care unit from 2008 to 2009 were included in this study and compared with 40 term-birth controls. The Korean Wechsler Intelligence Scale for Children-Fourth Edition, Advanced Test of Attention (ATA), Stroop test, Children's Color Trails Test (CCTT), and Wisconsin Card Sorting Test (WCST) were used.Additionally, the Korean Child Behavior Checklist (K-CBCL) and Korean ADHD Rating Scale (K-ARS) were completed. Perinatal and demographic data were collected and analyzed.
Results:
The mean full-scale intelligence quotient (FSIQ) score in the EP group was significantly lower than that of the term control group (89.1 ± 18.3 vs. 107.1 ± 12.7; P < 0.001).In the EP group, 26 (37%) children had an FSIQ score below 85, compared to only one child (3%) in the control group. Furthermore, the EP group showed significantly worse EF test results (ATA, Stroop test, CCTT, WCST). Except for the higher social immaturity subscore in the EP group, the K-CBCL and K-ARS scores were not different between the two groups. EP children who received laser treatment for retinopathy of prematurity (ROP) had an 8.8-fold increased risk of a low FSIQ score, and a 1-point increase in the discharge weight Z-score decreased the risk of a low FSIQ score by approximately half in this EP cohort.
Conclusion
This is the first Korean study to investigate the cognitive and behavioral outcomes of school-aged children born EP. In the study cohort, EP children exhibited significantly lower FSIQ scores and EF than their full-term peers, and 37% of them had cognitive problems. Nonetheless, except for social immaturity, the behavioral problems werenot different in EP children. Severe ROP and low discharge weight Z-score were identified as independent risk factors for low FSIQ score after adjusting for birth weight.

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