PURPOSE: To compare the oral feeding tolerance that reflects a general maturity of organization of behavior and response among preterm twins less than 34 weeks of gestation conceived after in vitro fertilization with/without embryo transfer (IVF-ET) with that of natural conception. METHODS: Medical records of 135 preterm twins less than 34 weeks of gestation (74 twins conceived after IVF-ET and 61 spontaneously conceived twins) admitted to the Neonatal Intensive Care Unit (NICU) of Dong-A Medical Center during the period from January 2003 to December 2010 were used for a retrospective study. The primary study outcomes were perinatal mortality and overall short term morbidity. The secondary study outcome was oral feeding tolerance. RESULTS: There was no difference among the two groups in the gestational age and birth weight. Perinatal mortality rate and morbidity rate was not different between the two groups. In terms of feeding practice, there was no significant difference in terms of the starting date of first enteral feeding (4.1+/-4.5 days vs. 3.5+/-3.6 days, IVF-ET twin group vs. spontaneous twin group), the time it took to reach full enteral feeding (26.7+/-20.5 days vs. 27.6+/-24.3 days), the time it took to reach full oral feeding (34.4+/-21.7 days vs. 34.3+/-24.1 days) and PMA upon full oral feeding (36.0+/-2.2 weeks vs. 36.0+/-1.8 weeks), the duration of total parenteral nutrition (23.1+/-21.0 days vs. 24.9+/-24.3 days), displaying similar oral feeding tolerance. CONCLUSION: There was no difference in oral feeding tolerance between two groups.
Birth Weight ; Embryo Transfer ; Enteral Nutrition ; Fertilization in Vitro ; Gestational Age ; Humans ; Infant, Newborn ; Intensive Care, Neonatal ; Medical Records ; Parenteral Nutrition, Total ; Perinatal Mortality ; Pregnancy ; Pregnancy, Twin ; Retrospective Studies

Early, aggressive nutrition is an important contributing factor of long-term neurodevelopmental outcomes. To ensure optimal growth in premature infants, adequate protein intake and optimal protein/energy ratio should be emphasized rather than the overall energy intake. Minimal enteral nutrition should be initiated as soon as possible in the first days of life, and feeding advancement should be individualized according to the clinical course of the infant. During hospitalization, enteral nutrition with preterm formula and fortified human milk represent the best feeding practices for facilitating growth. After discharge, the enteral nutrition strategy should be individualized according to the infant's weight at discharge. Infants with suboptimal weight for their postconceptional age at discharge should receive supplementation with human milk fortifiers or nutrient-enriched feeding, and the enteral nutrition strategy should be reviewed and modified continuously to achieve the target growth parameters.
Energy Intake ; Enteral Nutrition* ; Hospitalization ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Milk, Human

Spontaneous pneumomediastinum in a term newborn without mechanical ventilation or underlying lung disease is rare. We present a case of a newborn baby who developed respiratory distress after birth and cystic pneumomediastinum which improved spontaneously with thymic hyperplasia as demonstrated on chest radiography, CT and MRI. The combination of cystic pneumomediastinum and thymic hyperplasia in a newborn has not been reported, thus far.
Humans ; Hyperplasia ; Infant, Newborn ; Lung Diseases ; Mediastinal Emphysema ; Parturition ; Respiration, Artificial ; Thorax ; Thymus Gland ; Thymus Hyperplasia

PURPOSE: To evaluate the risk factors for hospital readmission during the neonatal period among late preterm infants who were discharged after nursery care. METHODS: In this retrospective study, we reviewed medical records of 135 late preterm infants readmitted to the neonatal intensive care unit (NICU) during the neonatal period, after discharge from nursery of IL Sin Christian Hospital from January 2003 to December 2008. We compared the risk factors of the hospital readmission group with the control group. RESULTS: The gestational age and birth weight of 135 study infants were 36(+1)+/-0.5 weeks and 2,718.4+/-296.9 gm, respectively. Identified risk factors of hospital readmission were breastfeeding (71.9% vs. 44.4%), short duration of nursery stay (3.3+/-1.6 days vs. 4.1+/-2.0 days), firstborn (60.0% vs. 45.3%), and maternal pregnancy complication (31.9% vs. 18.8%). Jaundice accounted for the majority of hospital readmissions (83.7%), and the age at hospital readmission was 6.2+/-3.6 postnatal days, mostly at 5-6 postnatal days (40.7%). Identified risk factors of hospital readmission due to jaundice were spontaneous normal vaginal delivery (43.4% vs. 1.8%), younger maternal age (29.8+/-3.4 yrs vs. 32.1+/-4.2 yrs), and lower maternal pregnancy complication (28.3% vs. 50%). CONCLUSION: Identified risk factors of hospital readmission were breastfeeding, short duration of nursery stay, firstborn, and maternal pregnancy complication. Jaundice accounted for the majority of hospital readmissions, and the age at hospital readmission was 6.2+/-3.6 postnatal days.
Birth Weight ; Breast Feeding ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Intensive Care, Neonatal ; Jaundice ; Maternal Age ; Medical Records ; Nurseries ; Patient Readmission ; Pregnancy Complications ; Retrospective Studies ; Risk Factors

PURPOSE: Little is known about the duration of antibiotics for suspected early-onset sepsis (EOS) with negative blood cultures. The purpose of this study is to identify associations between the duration of empirical antibiotics and neonatal outcomes. METHODS: We retrospectively reviewed medical records of very low birth weight infants (VLBW) who admitted to NICU in 2007-2010. We defined empirical antibiotic therapy group as those who started antibiotic therapy in first 3 postnatal days. We compared the neonatal outcomes between short empirical antibiotic therapy (<5 days) and long empirical antibiotic therapy (> or =5 days). RESULTS: Of 122 VLBW, 72 infants were long empirical antibiotic therapy group. In the long empirical antibiotic therapy group, there were lower birth weight, higher rate of out-born, higher rate of vaginal delivery, and had lower Apgar scores. Prolonged antibiotic therapy was associated with delayed start of enteral feeding and incidence of ESBL. CONCLUSION: Prolonged antibiotic therapy may be associated with some adverse neonatal outcomes. Therefore, wide spread agreement regarding the short empirical antibiotic therapy was needed.
Anti-Bacterial Agents ; Birth Weight ; Enteral Nutrition ; Humans ; Incidence ; Infant ; Infant, Very Low Birth Weight ; Medical Records ; Retrospective Studies ; Sepsis

Meconium aspiration syndrome (MAS) is defined as respiratory distress in newborn infants born through meconium-stained amniotic fluid whose symptoms cannot be otherwise explained. MAS is characterized by hypoxemia, hypercapnia and acidosis that continues to be associated with signifi cant morbidities and mortality. Worldwide, the incidence has declined due to improved obstetric and perinatal care. The pathophysiological mechanism of MAS include perinatal hypoxia, acute airway obstruction, pulmonary and systemic inflammation, surfactant inactivation and persistent pulmonary hypertension of the newborn (PPHN). Respiratory and hemodynamic supports are main therapies for MAS. Early identification and appropriate management of PPHN is important as it associates with significant mortality and morbidities. This review suggests a comprehensive overview of the epide miology, diagnosis, management, prognosis and prevention of MAS.

Meconium aspiration syndrome (MAS) is defined as respiratory distress in newborn infants born through meconium-stained amniotic fluid whose symptoms cannot be otherwise explained. MAS is characterized by hypoxemia, hypercapnia and acidosis that continues to be associated with signifi cant morbidities and mortality. Worldwide, the incidence has declined due to improved obstetric and perinatal care. The pathophysiological mechanism of MAS include perinatal hypoxia, acute airway obstruction, pulmonary and systemic inflammation, surfactant inactivation and persistent pulmonary hypertension of the newborn (PPHN). Respiratory and hemodynamic supports are main therapies for MAS. Early identification and appropriate management of PPHN is important as it associates with significant mortality and morbidities. This review suggests a comprehensive overview of the epide miology, diagnosis, management, prognosis and prevention of MAS.

Meconium aspiration syndrome (MAS) is defined as respiratory distress in newborn infants born through meconium-stained amniotic fluid whose symptoms cannot be otherwise explained. MAS is characterized by hypoxemia, hypercapnia and acidosis that continues to be associated with signifi cant morbidities and mortality. Worldwide, the incidence has declined due to improved obstetric and perinatal care. The pathophysiological mechanism of MAS include perinatal hypoxia, acute airway obstruction, pulmonary and systemic inflammation, surfactant inactivation and persistent pulmonary hypertension of the newborn (PPHN). Respiratory and hemodynamic supports are main therapies for MAS. Early identification and appropriate management of PPHN is important as it associates with significant mortality and morbidities. This review suggests a comprehensive overview of the epide miology, diagnosis, management, prognosis and prevention of MAS.

Meconium aspiration syndrome (MAS) is defined as respiratory distress in newborn infants born through meconium-stained amniotic fluid whose symptoms cannot be otherwise explained. MAS is characterized by hypoxemia, hypercapnia and acidosis that continues to be associated with signifi cant morbidities and mortality. Worldwide, the incidence has declined due to improved obstetric and perinatal care. The pathophysiological mechanism of MAS include perinatal hypoxia, acute airway obstruction, pulmonary and systemic inflammation, surfactant inactivation and persistent pulmonary hypertension of the newborn (PPHN). Respiratory and hemodynamic supports are main therapies for MAS. Early identification and appropriate management of PPHN is important as it associates with significant mortality and morbidities. This review suggests a comprehensive overview of the epide miology, diagnosis, management, prognosis and prevention of MAS.

Meconium aspiration syndrome (MAS) is defined as respiratory distress in newborn infants born through meconium-stained amniotic fluid whose symptoms cannot be otherwise explained. MAS is characterized by hypoxemia, hypercapnia and acidosis that continues to be associated with signifi cant morbidities and mortality. Worldwide, the incidence has declined due to improved obstetric and perinatal care. The pathophysiological mechanism of MAS include perinatal hypoxia, acute airway obstruction, pulmonary and systemic inflammation, surfactant inactivation and persistent pulmonary hypertension of the newborn (PPHN). Respiratory and hemodynamic supports are main therapies for MAS. Early identification and appropriate management of PPHN is important as it associates with significant mortality and morbidities. This review suggests a comprehensive overview of the epide miology, diagnosis, management, prognosis and prevention of MAS.