PURPOSE: Although neonatal pulmonary hemorrhage is rare, it is associated with high mortality. We aimed to evaluate the risk factors associated with pulmonary hemorrhage in preterm infants and to describe the clinical course, including neonatal morbidity, of infants who developed pulmonary hemorrhage. METHODS: We performed a retrospective case-control study of 117 newborn infants aged less than 37 gestational weeks admitted to the neonatal intensive care unit of Daegu Fatima Hospital between January 1995 and December 2008. Control group infants without pulmonary hemorrhage were matched according to the gestational age, duration of mechanical ventilation, and birth weight range (< or =100 g). Pulmonary hemorrhage was defined as the presence of hemorrhagic fluid in the trachea and severe respiratory decompensation. RESULTS: Pulmonary hemorrhage occurred in 17 cases of very low birth weight infants (VLBW; birth weight < 1,500 g; median age, 3 days) and 22 cases of low birth weight infants (LBW; 1,500 g < or = birth weight < 2,500 g; median age, 1 day). Antenatal maternal glucocorticoid treatment significantly reduced the incidence of pulmonary hemorrhage in VLBW infants. Low APGAR score (< or =3 at 1 min) and acidosis at birth were associated with significantly high incidence of pulmonary hemorrhage in LBW infants. CONCLUSION: Antecedent factors and timing of pulmonary hemorrhage of LBW infants were different from those of VLBW infants. The mortality rates of VLBW and LBW infants were 88.2% and 45.5%, respectively. Pulmonary hemorrhage was the principal cause of death in 66.6% VLBW infants and 40.0% LBW infants.
Acidosis ; Aged ; Apgar Score ; Birth Weight ; Case-Control Studies ; Cause of Death ; Gestational Age ; Hemorrhage ; Humans ; Incidence ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Intensive Care, Neonatal ; Parturition ; Prognosis ; Respiration, Artificial ; Retrospective Studies ; Risk Factors ; Trachea

PURPOSE: In contrast with traditional time-cycled, pressure-limited ventilation, during volume-controlled ventilation, a nearly constant tidal volume is delivered with reducing volutrauma and the episodes of hypoxemia. The aim of this study was to compare the efficacy of pressure-regulated, volume controlled ventilation (PRVC) to Synchronized intermittent mandatory ventilation (SIMV) in VLBW infants with respiratory distress syndrome (RDS). METHODS: 34 very low birth weight (VLBW) infants who had RDS were randomized to receive either PRVC or SIMV with surfactant administration : PRVC group (n=14) and SIMV group (n=20). We compared peak inspiratory pressure (PIP), duration of mechanical ventilation, and complications associated with ventilation, respectively with medical records. RESULTS: There were no statistical differences in clinical characteristics between the groups. After surfactant administration, PIP was significantly lower during PRVC ventilation for 48hrs and accumulatevive value of decreased PIP was higher during PRVC ventilation for 24hrs (P <0.05). Duration of ventilation and incidence of complications was no significant difference. CONCLUSION: PRVC is the mode in which the smallest level of PIP required to deliver the preset tidal volume in VLBW infants with RDS, adaptively responding to compliance change in lung after surfactant replacement.
Anoxia ; Compliance ; Humans ; Incidence ; Infant ; Infant, Very Low Birth Weight ; Lung ; Respiration, Artificial ; Respiratory Distress Syndrome, Newborn ; Tidal Volume ; Ventilation

PURPOSE: Advances in neonatal intensive care have improved the survival rate of low-birth-weight infants, but mild bronchopulmonary dysplasia (BPD) with the accompanying need for prolonged oxygen supplement remains problematic. Maternal chorioamnionitis and neonatal ventilator care affect the development of BPD. This study aimed to examine whether maternal chorioamnionitis or neonatal ventilator care affect the development of BPD dependently or independently. METHODS: We performed a retrospective study of 158 newborn infants below 36 weeks of gestational age and 1,500 gm birth weight admitted to the neonatal intensive care unit of Daegu Fatima Hospital between January 2000 and December 2006. We analyzed the incidence of BPD according to maternal chorioamnionitis and neonatal ventilator care. Result: Histologic chorioamnionitis was observed in 50 of 158 infants (31.6%). There were no significant differences in the development of BPD (P=0.735) between the chorioamnionitis (+) and chorioamnionitis (-) groups. In the multiple regression analysis, ventilator care (OR=7.409, 95% CI=2.532-21.681) and neonatal sepsis (OR=4.897, 95% CI=1.227-19.539) affected the development of BPD rather than maternal chorioamnionitis (OR=0.461, 95% CI=0.201-1.059). CONCLUSION: Ventilator care or neonatal sepsis may play a role in the development of BPD rather than maternal chorioamnionitis.
Birth Weight ; Bronchopulmonary Dysplasia ; Chorioamnionitis ; Female ; Gestational Age ; Humans ; Incidence ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Intensive Care, Neonatal ; Oxygen ; Pregnancy ; Retrospective Studies ; Sepsis ; Survival Rate ; Ventilators, Mechanical

PURPOSE: This study aimed to determine the influence of low-dose oxygen (FiO2 <25%) therapy through nasal cannulae on the progress and prognosis of retinopathy of prematurity (ROP) as well as methods of preventing ROP. METHODS: Our subjects comprised premature infants (gestation period <37 weeks; birth weight <1,750 g) born in Daegu Fatima Hospital between February 1,2001 and January 31,2006. We retrospectively reviewed and analyzed the medical records of 273 patients who were available for eye examination and follow up over 6 months. RESULTS: The factors maximally influencing the occurrence of ROP were low gestation age and low birth weight. We observed that the incidence of ROP increased with the increasing duration of low-dose oxygen therapy. ROP onset was delayed during ongoing oxygen therapy; however, rapid progression of ROP occurred after the discontinuation of oxygen therapy among premature infants up to the prethreshold stage. CONCLUSION: To prevent of occurrence of severe ROP and its rapid progression, the period of low-dose oxygen therapy needs to be shortened. Moreover, frequent eye examinations should be performed after the discontinuation of oxygen therapy.
Birth Weight ; Catheters ; Diterpenes ; Eye ; Follow-Up Studies ; Humans ; Incidence ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Lung Diseases ; Medical Records ; Oxygen ; Pregnancy ; Prognosis ; Retinopathy of Prematurity ; Retrospective Studies ; Risk Factors

PURPOSE: Early surfactant treatment and minimal ventilation, bronchopulmonary dysplasia needed prolonged oxygen supplement is a problem. This study aimed to report the effects of early surfactant treatment and minimal ventilation on the prevention of bronchopulmonary dysplasia in respiratory distress syndrome. METHODS: We retrospectively studied 139 premature newborn infants (gestational age, 36 weeks; birth weight, 1,500 gm) admitted to the neonatal intensive care unit of Daegu Fatima Hospital between January 2001 and December 2006. We analyzed the occurrence of bronchopulmonary dysplasia with respect to ventilator care and surfactant treatment. RESULTS: The incidence of bronchopulmonary dysplasia was significantly higher with prolonged ventilator care, moderate to severe respiratory distress syndrome, and low Apgar score (P<0.001). Despite early surfactant treatment and minimal ventilation, mild bronchopulmonary dysplasia occurs in a considerable number of patients with mild respiratory distress syndrome. The patient group with low Apgar scores required ventilator care for a prolonged period (P=0.020). CONCLUSION: Early surfactant treatment and minimal ventilation shortens the duration of ventilator care; however, the preventive effe cts on bronchopulmonary dysplasia are limited. The refore, not only early surfactant treatment and minimal ventilation but also appropriate management in the delivery room is essential.
Apgar Score ; Birth Weight ; Bronchopulmonary Dysplasia ; Delivery Rooms ; Humans ; Incidence ; Infant, Newborn ; Intensive Care, Neonatal ; Oxygen ; Retrospective Studies ; Ventilation ; Ventilators, Mechanical

PURPOSE: Pulmonary interstitial emphysema (PIE) primarily occurs in preterm infants suffering from respiratory distress syndrome (RDS) and kept under mechanical ventilator care. Therefore, this study aimed to examine various risk factors for PIE, to identify conditions that can decrease the possibility of PIE development. METHODS: PIE classification was conducted for 183 patients diagnosed to have RDS and receiving mechanical ventilator care with pulmonary surfactant between March 2000 and February 2007. The characteristics of each patient were analyzed through retrospective examination of their medical histories. RESULTS: Among 183 patients, 17 had PIE; all factors, including birth weight, gestational age, RDS grade III or above, chorioamnionitis, and premature rupture of membranes, were statistically significant (P<0.05). The period of mechanical ventilator use was statistically significant, but the peak mean airway pressure and peak partial pressure of inspired oxygen were not. PIE mainly occurred on the right side or both sides rather than the left side and mostly developed within 72 h. The PIE group showed higher mortality rate than the control group, and the major cause of mortality was pneumothorax. CONCLUSION: Risk factors for PIE in infants suffering from RDS and kept under mechanical ventilator care include low gestational age, low birth weight, chorioamnionitis, and premature rupture of membranes. If any risk factors are noted, the infant must be observed closely for at least 72 h after birth.
Birth Weight ; Chorioamnionitis ; Emphysema ; Female ; Gestational Age ; Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Membranes ; Oxygen ; Partial Pressure ; Parturition ; Pneumothorax ; Pregnancy ; Pulmonary Surfactants ; Retrospective Studies ; Risk Factors ; Rupture ; Stress, Psychological ; Ventilators, Mechanical

PURPOSE: As modern society has became more open, interest in healthy internal and external growth has increased, including that pertaining to penile length in children. A micropenis is defined as one where penile length is more than 2 SD (standard deviation) below the mean, and it can be traced back to chromosome and endocrine disorders. The authors executed this study to suggest guidelines for the study of the micropenis and standard information for penile length in Korean newborns. METHODS: The subjects of this study were 168 male infants between 37 and 42 weeks of gestational age, none of whom had any complications during pregnancy or birth; each had been born in Daegu Fatima Hospital between February and June 2007. Penile length was measured using conventional stretched penile length measurement (CPLM) and syringe methods. RESULTS: Penile length was 3.02+/-0.25 cm (F=36.467, R(2)=0.180, P<0.001) when measured with CPLM, and 3.29+/-0.26 cm (F=9.149, R(2)=0.052, P<0.001) with the syringe method. There was no statistically significant difference in the penile length of newborn infants as a result of taking measurements with the two methods, and both methods showed significance at 0.631 in terms of Pearson's correlation coefficient, at the level of P=0.01. CONCLUSION: In this study, penile length tended to be longer when gestational age was longer, and a micropenis can be assumed to be one less than 2.5 cm using CPLM and less than 2.8 cm using the syringe method. In the case of a concealed penis, the syringe method is helpful. When a micropenis is assumed, close observation by outpatient department personnel, and additional endocrine and chromosome studies should be undertaken after sufficiently consulting the parents.
Child ; Genital Diseases, Male ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Male ; Outpatients ; Parents ; Penis ; Pregnancy ; Reference Values ; Syringes

PURPOSE: As modern society has became more open, interest in healthy internal and external growth has increased, including that pertaining to penile length in children. A micropenis is defined as one where penile length is more than 2 SD (standard deviation) below the mean, and it can be traced back to chromosome and endocrine disorders. The authors executed this study to suggest guidelines for the study of the micropenis and standard information for penile length in Korean newborns. METHODS: The subjects of this study were 168 male infants between 37 and 42 weeks of gestational age, none of whom had any complications during pregnancy or birth; each had been born in Daegu Fatima Hospital between February and June 2007. Penile length was measured using conventional stretched penile length measurement (CPLM) and syringe methods. RESULTS: Penile length was 3.02+/-0.25 cm (F=36.467, R(2)=0.180, P<0.001) when measured with CPLM, and 3.29+/-0.26 cm (F=9.149, R(2)=0.052, P<0.001) with the syringe method. There was no statistically significant difference in the penile length of newborn infants as a result of taking measurements with the two methods, and both methods showed significance at 0.631 in terms of Pearson's correlation coefficient, at the level of P=0.01. CONCLUSION: In this study, penile length tended to be longer when gestational age was longer, and a micropenis can be assumed to be one less than 2.5 cm using CPLM and less than 2.8 cm using the syringe method. In the case of a concealed penis, the syringe method is helpful. When a micropenis is assumed, close observation by outpatient department personnel, and additional endocrine and chromosome studies should be undertaken after sufficiently consulting the parents.
Child ; Genital Diseases, Male ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Male ; Outpatients ; Parents ; Penis ; Pregnancy ; Reference Values ; Syringes

PURPOSE: The present study examined the etiology and risk factors of the early breast-feeding jaundice and the usefulness of auditory brainstem response test as early predictor of kernicterus. METHODS: Medical records of neonatal jaundice in newborn admitted to Daegu Fatima Hospital between September 2005 and May 2006 were analyzed prospectively. Infants were grouped according to feeding method:breast feeding group (breast feeding only, n=23), mixed feeding group (breast feeding mainly plus addition of fomula feeding, n=13). RESULTS: There were no significant differences in gestational age, birth weight, sex, duration of phototherapy, serum bilirubin and hemolytic evidence between the two study groups. First visiting day of life at out patient department was significantly delayed in breast feeding group (8.7+/-3.6 day) compared to mixed feeding group (6.0+/-1.9) (P=0.009). Weight loss was significantly severe in breast feeding group compared to mixed feeding group (P<0.05). In auditory brainstem response test, loss of Wave V in 3 cases was observed and recoverd after blood exchange transfusion in follow up test. Wave III latency had significant correlation to serum bilirubin in auditory brainstem response test (70 dB) (P=0.002). CONCLUSION: Our study suggest that further education about breast feeding and follow up within the first postnatal week would be necessary for early detection and prevention of early breast-feeding jaundice. Test of serum bilirubin and auditory brainstem response would be helpful in determination of blood exchange transfusion.
Bilirubin ; Birth Weight ; Breast Feeding ; Daegu ; Education ; Evoked Potentials, Auditory, Brain Stem* ; Follow-Up Studies ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Jaundice* ; Jaundice, Neonatal ; Kernicterus* ; Medical Records ; Phototherapy ; Prospective Studies ; Risk Factors ; Weight Loss

Cornelia de Lange syndrome is characterized by severe growth and mental retardation, characteristic face, and a low-pitched, weak, growling cry, which was first described by Cornelia de Lange in 1933. We have recognized Cornelia de Lange syndrome with imperforate anus in a male neonate. The patient had the typical facial appearance: micrognathia, confluent eyebrows, long curly eyelashes, underdeveloped orbital arches, long philtrum, thin lip, downturned angles of the mouth, anteverted nares, low-set ears, high-arched palate, and generalized hirsutism. His karyotype was normal, but skeletal abnormalities of the hands, cryptorchism, and imperforate anus with rectourethral fistula. A colostomy was performed on the third day of hospitalization.
Anus, Imperforate* ; Colostomy ; Cryptorchidism ; De Lange Syndrome* ; Ear ; Eyebrows ; Eyelashes ; Fistula ; Hand ; Hirsutism ; Hospitalization ; Humans ; Infant, Newborn ; Intellectual Disability ; Karyotype ; Lip ; Male ; Mouth ; Orbit ; Palate