Infants, born with a birth weight above 4.0 kg, are categorized as high birth weight infant (HBWI). The term HBWI is often used in similar context with macrosomia. Macrosomia is associated with many complications, and is considered to be a high risk group that requires an intensive care in most cases. This report is presenting an extreme macrosomia born at a gestational age of 38+5 weeks, with a body weight of 6.14 kg. The infant was born by a cesarean section from a mother with diabetes, and was admitted into an intensive care unit with tachypnea, which had occurred soon after birth. There were other complications, such as hypoglycemia, hypocalcemia, secondary atrial septal defect, patent ductus arteriosus, pulmonary hypertestion, and etc. With conservative management, the symptoms improved over a 10 day course and the patient was discharged from the hospital. To this day, the child has not presented with further health problems during the 6 months of follow up period. We reviewed the frequency and trend of the births of HBWI, through the raw data from the Statistics Korea on births between 2000 and 2010. With additional analysis of the cases of macrosomia, through the years of 1964 to 2011, we were able to find 7 reports, including this current case of infants born with a body weight above 6.0 kg. This case was the fifth heaviest infant among these 7 cases. We are reporting this case with the hope that it may contribute to the future care of high risk infants in a neonatal intensive care unit.
Benzeneacetamides ; Birth Weight ; Body Weight ; Cesarean Section ; Child ; Ductus Arteriosus, Patent ; Female ; Follow-Up Studies ; Gestational Age ; Heart Septal Defects, Atrial ; Humans ; Hypocalcemia ; Hypoglycemia ; Infant ; Infant, Newborn ; Critical Care ; Intensive Care Units ; Intensive Care, Neonatal ; Korea ; Mothers ; Parturition ; Piperidones ; Pregnancy ; Tachypnea

Neonatal upper gastrointestinal bleeding is rare in healthy full term infants and is known to be caused by stress ulcer, intracranial hemorrhage, increased intracranial pressure, congenital heart disease, perinatal asphyxia, respiratory distress, hypoglycemia and use of drugs such as steroids. Mallory-Weiss syndrome and hemorrhagic gastritis can cause life threatening upper gastrointestinal bleeding and are rarely reported in neonates and young infants. The authors experienced a case of Mallory-Weiss syndrome in a full term infant without particular perinatal history and a case of acute hemorrhagic gastritis in a preterm infant born at 33 weeks of gestation and 2,260 g of birth weight, both showed life threatening upper gastrointestinal bleeding. We report these two cases with a review of current literature.
Asphyxia ; Birth Weight ; Gastritis ; Gastrointestinal Hemorrhage ; Heart Diseases ; Hemorrhage ; Humans ; Hypoglycemia ; Infant ; Infant, Newborn ; Infant, Premature ; Intracranial Hemorrhages ; Intracranial Pressure ; Mallory-Weiss Syndrome ; Pregnancy ; Steroids ; Ulcer

Cutis marmorata telangiectatica congenita (CMTC) is a rare congenital vascular disorder, and its pathophysiology is still unclear and most cases occur sporadically. Cutaneous lesions are observed at birth with a marbled bluish and deep-purple appearance. The associated anomaly is manifest as body asymmetry, macrocephaly, hydrocephalus, mental retardation, syndactyly and congenital glaucoma. We report our experience of CMTC1 in a female infant with the gestational age of 34 weeks and 6 days and birth weight of 2,300 g who was born by cesarean section with abnormal skin lesions. The cutaneous lesions covered most of the lower body and they faded as she continues to grow. She also had onychodysplasia in her left 2nd phalanges. In this case, close follow up by not only pediatricians but also ophthalmologist and neurologists to treat various forms of lesions involved, though the prognosis of CMTC is generally good.
Birth Weight ; Cesarean Section ; Female ; Follow-Up Studies ; Gestational Age ; Glaucoma ; Humans ; Hydrocephalus ; Infant ; Intellectual Disability ; Macrocephaly ; Parturition ; Pregnancy ; Prognosis ; Skin ; Skin Diseases, Vascular ; Syndactyly ; Telangiectasis ; Vascular Malformations

PURPOSE: The aim of this study is to characterize and to investigate the factors related to the recurrence of febrile urinary tract infection (UTI) in infants less than 2 months of age. METHODS: We performed a retrospective study in 60 infants, who were treated for the first febrile UTI. Among them, 27 infants were followed for 12 months, and were reviewed concerning the factors related to the recurrence. The factors compared for the recurrence included sex, age at diagnosis, laboratory and radiologic findings like degree of the reflux and renal cortical defect. RESULTS: Among the 60 infants studied, 52 were male (86.7%). Age at diagnosis was 39+/-13 days. The most common pathogen was E.coli (71.7%). The infants underwent an ultrasonography (n=59), DMSA scan (n=55), and voiding cystourethrography (VCUG). Further hydronephrosis, renal cortical defect, vesicoureteral reflux (VUR) were found in 28 (47.4%), 12 (21.8%) and 11 (20.4%) infants, respectively. The hydronephrosis was found frequently in the recurrent UTI group (P=0.012). The VUR was found frequently, but not significantly, in therecurrent UTI group (44.4%) than that of the non-recurrent UTI group (16.7%). CONCLUSION: During the 12 months after the first febrile UTI, hydronephrosis increased the risk of recurrent UTI. The ultrasonography is needed during the follow up of UTI in infants less than two months of age.
Clinical Laboratory Techniques ; Follow-Up Studies ; Humans ; Hydronephrosis ; Infant ; Male ; Recurrence ; Retrospective Studies ; Succimer ; Urinary Tract ; Urinary Tract Infections ; Vesico-Ureteral Reflux

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

PURPOSE: In preterm infants, neonatologists often encounter abnormally high level of 17-alpha-hydroxy progesterone (17-OHP), however as there is no normative reference level for Korean preterm neonates, repeated tests for 17-OHP are conducted until the level reaches the normal value of term infants. The aim for the study is to investigate the longitudinal follow up of 17 OHP levels according to gestational age. METHODS: The samples for 17-OHP were obtained as tandem mass spectrometry (TMS) by heel prick between the 3rd and 7th day of life from 1,040 preterm infants who were born at Asan Medical Center from June 2008 to June 2010. If initial 17-OHP level was abnormal (>12 ng/mL), the serum levels were followed every 2-4 weeks until normalization. RESULTS: The mean levels of 17-OHP obtained from initial TMS according to gestational age were as follows: 24-26 weeks (26.4+/-20.7 ng/mL, n=20); 27-28 weeks (14.8+/-14.6 ng/mL, n=39); 29-30 weeks (7.6+/-7.3 ng/mL, n=54); 31-32 weeks (5.1+/-5.8 ng/mL, n=86); 33-34 weeks (4.6+/-3.9 ng/mL, n=186); 35 weeks (5.0+/-5.5 ng/mL, n=251); and 36 week (3.6+/-2.3 ng/mL, n=403). The mean and 99.5 percentile 17-OHP levels correlated inversely with gestational age. Those 63 infants (mean gestational age 28.6+/-4.1 weeks) whose initial 17-OHP levels were abnormally high, all became normalized at mean of 67.2+/-49.0 days. The mean number of follow-up was 2.9+/-1.9 times (range: 1-7 times) until normalization. CONCLUSION: The 17-OHP levels correlated inversely with gestational age and the number of false-positive results in the absence of congenital adrenal hyperplasia is high among preterm population. The percentile values presented here for 17-OHP in relation to gestational age could serve as a useful guideline for 17-OHP level follow up.
Adrenal Hyperplasia, Congenital ; Follow-Up Studies ; Gestational Age ; Heel ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Neonatal Screening ; Progesterone ; Reference Values ; Tandem Mass Spectrometry

I report a case of extremely low birth weight infant, who presented central diabetes insipidus associated with cytomegalovirus infection. His brain magnetic resonance imaging showed a flattened pituitary gland, and demonstrated a lack of posterior pituitary hyperintensity. It successfully managed with oral desmopressin (Minirin(R)) and persisted beyond the resolving of symptomatic cytomegalovirus infection.
Brain ; Cytomegalovirus ; Cytomegalovirus Infections ; Deamino Arginine Vasopressin ; Diabetes Insipidus, Neurogenic ; Humans ; Infant, Extremely Low Birth Weight ; Infant, Newborn ; Magnetic Resonance Imaging ; Pituitary Gland

Bronchial injury is a rare and serious complication of endotracheal intubation in neonates. Bronchial perforation following tracheal intubation causes a high-volume air leak mimicking pneumothorax and pneumomediastinum, and it may result in intraventricular hemorrhage, mediastinitis and sepsis. I report my experience of diagnosing a main bronchial perforation in an extremely low birth weight infant, who had a high-volume air leak following tracheal intubation, which persisted after chest tube insertion.
Chest Tubes ; Hemorrhage ; Humans ; Infant, Extremely Low Birth Weight ; Infant, Newborn ; Intubation ; Intubation, Intratracheal ; Mediastinal Emphysema ; Mediastinitis ; Pneumothorax ; Sepsis

Hallermann-Streiff syndrome is a very rare congenital disorder, which is primarily characterized by the head and face abnormalities. Approximately 180 cases have been reported worldwide, including 8 cases in Korea since it was first described by Hallermann in 1893. Patients exhibit a bird-like face, hypotrichosis, atrophy of skin, dental abnormalities, proportionate nanism, and various ophthalmic disorders, including congenital cataracts and bilateral micropthalmia. As a result of many life-threatening complications, such as respiratory and cardiac difficulties, many patients die during infancy. We report here two cases of HSS diagnosed immediately after birth with literature reviews. They showed two additional characteristics, including chubby cheeks and antenatal ultrasonographic findings, which have not been mentioned in previous reports.
Atrophy ; Cataract ; Cheek ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Dwarfism ; Hallermann's Syndrome ; Head ; Humans ; Hypotrichosis ; Korea ; Microphthalmos ; Parturition ; Skin

PURPOSE: Premature and low birth weighted (LBW) infants as well as small for gestational age (SGA) infants have a high death rate and increasing the prevalence rate. We compared the proportion of these high-risk neonates and the relevant factor between the four regional settings. METHODS: We reviewed the data from 2005 to 2010, from the Korea National Statistics Office and compared the proportions of premature infants, LBW infants and SGA babies and the relevant factors between Seoul, metropolitan cities and small-to-medium-sized ones. RESULTS: Premature birth rate is as follows in each area: 4.00% in Seoul, 4.21% in metropolitan areas, 4.11% in small and medium size cities, and 4.27% in small towns. SGA birth rate is slightly lower in the medium-sized cities and higher in small towns. The birth rate of low birth weight infants is higher only in small towns (3.58%). It appears that low maternal age and low maternal education levels increase these high-risk newborns. Once calibrated variables, the result showed that the risk of premature infants is higher in the metropolitan areas (OR, 1.05), and the risk of SGA (OR, 1.06) and low birth weight (1.03) is higher in a small town. CONCLUSIONS: There were significant differences in the premature infants, low birth weight infants and SGA babies between the four different regional settings. Following the adjustment of the relevant variables, the proportion premature infant was higher in metropolitan cities and SGA babies and LBW infants were higher in small ones.
Birth Rate ; Gestational Age ; Humans ; Incidence ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Korea ; Maternal Age ; Mothers ; Premature Birth ; Prevalence