Purpose: Inhaled nitric oxide (iNO) is a potent selective pulmonary vasodilator and an important treatment for newborn infants with hypoxic respiratory failure due to persistent pulmonary hypertension of the newborn (PPHN). The Ministry of Food and Drug Safety of Korea first approved iNO in 2009 for use as a new drug to treat hypoxic res piratory failure with PPHN. A post-marketing surveillance study (PMSS) was conducted to assess the effectiveness and safety of the iNO treatment. We evaluated the clinical status of the iNO treatment currently available in Korea by using the PMSS data. Methods: We retrospectively reviewed the PMSS data from 22 hospitals in Korea from October 2014 to September 2018. Altogether, 97 infants were enrolled and divided into early response (ER), delayed response (DR), no response (NR), and death groups according to their response to the iNO treatment. Results: The ER group included 52 infants (53.6%); DR group, 33 (34.0%); NR group, seven (7.2%); and death group, five (5.2%). The iNO treatment was initiated within 14 days after birth at a concentration of 20 ppm. The median treatment duration was 91.5 hours (69.0 to 134.3) in all the infants. Of the infants, 43 (44.3%) received the treatment for >96 hours. Fifty-one infants (52.6%) needed >20 ppm of iNO, and 10 (10.5%) needed a maximum of 80 ppm of iNO. None of the infants had hypermethemoglobinemia or an alarm report of NO2. Conclusion: Korean neonatologists reported that a large proportion of the infants with PPHN showed improvement in oxygenation after treatment with the approved iNO. These infants received relatively longer durations and higher concentrations of the iNO treatment than the current recommendations, without any side and adverse effect.
{"title":"Clinical Status of Inhaled Nitric Oxide Treatment in Infants with Persistent Pulmonary Hypertension of the Newborn in Korea: Post-Marketing Surveillance Results","authors":"J. Ha, Eun Hee Lee, Hyun-Kyung Park, B. Choi","doi":"10.5385/nm.2020.27.2.57","DOIUrl":"https://doi.org/10.5385/nm.2020.27.2.57","url":null,"abstract":"Purpose: Inhaled nitric oxide (iNO) is a potent selective pulmonary vasodilator and an important treatment for newborn infants with hypoxic respiratory failure due to persistent pulmonary hypertension of the newborn (PPHN). The Ministry of Food and Drug Safety of Korea first approved iNO in 2009 for use as a new drug to treat hypoxic res piratory failure with PPHN. A post-marketing surveillance study (PMSS) was conducted to assess the effectiveness and safety of the iNO treatment. We evaluated the clinical status of the iNO treatment currently available in Korea by using the PMSS data. Methods: We retrospectively reviewed the PMSS data from 22 hospitals in Korea from October 2014 to September 2018. Altogether, 97 infants were enrolled and divided into early response (ER), delayed response (DR), no response (NR), and death groups according to their response to the iNO treatment. Results: The ER group included 52 infants (53.6%); DR group, 33 (34.0%); NR group, seven (7.2%); and death group, five (5.2%). The iNO treatment was initiated within 14 days after birth at a concentration of 20 ppm. The median treatment duration was 91.5 hours (69.0 to 134.3) in all the infants. Of the infants, 43 (44.3%) received the treatment for >96 hours. Fifty-one infants (52.6%) needed >20 ppm of iNO, and 10 (10.5%) needed a maximum of 80 ppm of iNO. None of the infants had hypermethemoglobinemia or an alarm report of NO2. Conclusion: Korean neonatologists reported that a large proportion of the infants with PPHN showed improvement in oxygenation after treatment with the approved iNO. These infants received relatively longer durations and higher concentrations of the iNO treatment than the current recommendations, without any side and adverse effect.","PeriodicalId":32945,"journal":{"name":"Neonatal Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43029585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Since December 2019, the coronavirus disease 2019 (COVID-19) has been spreading rapidly worldwide With the increase in the number of infections, the numbers of pregnant women and newborn infants with COVID-19 are also increasing Accord ing to the limited recent studies, COVID-19 appears to be mainly transmitted to newborn infants by the mother’s droplets or direct contact with the mother, and no clear evidence supports the vertical transmission from the mother to the newborn infant To date, the likelihood of severe outcomes in newborn infants born to mothers with confirmed COVID-19 is relatively very low, but the possibility should be considered The present response guidelines address the management of newborn infants born to mothers with suspected or confirmed COVID-19 The management covers precautions for birth attendants or medical staffs, testing for COVID-19, isolation, neonatal care, breastfeeding, and mother/baby contact These response guidelines can be revised in accordance with further updates on COVID-19 and should be adapted to each local health-care facility
{"title":"Response Guidelines for Newborn Infants Born to Mothers with Suspected or Confirmed Coronavirus Disease 2019","authors":"Do-Hyun Kim","doi":"10.5385/nm.2020.27.2.45","DOIUrl":"https://doi.org/10.5385/nm.2020.27.2.45","url":null,"abstract":"Since December 2019, the coronavirus disease 2019 (COVID-19) has been spreading rapidly worldwide With the increase in the number of infections, the numbers of pregnant women and newborn infants with COVID-19 are also increasing Accord ing to the limited recent studies, COVID-19 appears to be mainly transmitted to newborn infants by the mother’s droplets or direct contact with the mother, and no clear evidence supports the vertical transmission from the mother to the newborn infant To date, the likelihood of severe outcomes in newborn infants born to mothers with confirmed COVID-19 is relatively very low, but the possibility should be considered The present response guidelines address the management of newborn infants born to mothers with suspected or confirmed COVID-19 The management covers precautions for birth attendants or medical staffs, testing for COVID-19, isolation, neonatal care, breastfeeding, and mother/baby contact These response guidelines can be revised in accordance with further updates on COVID-19 and should be adapted to each local health-care facility","PeriodicalId":32945,"journal":{"name":"Neonatal Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43594775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Neonatal acute suppurative parotitis is rare. Staphylococcus aureus is the most com mon pathogen and antibiotic treatment is the first line therapy. Here, we report a case of acute suppurative parotitis caused by Escherichia coli in a 7dayold male with febrile sensation, parotid swelling, and purulent discharge from the Stensen duct who was treated successfully with intravenous antibiotics. To the best of our knowledge, this is the first case of neonatal suppurative parotitis caused by E. coli in Korea.
{"title":"The First Case of Acute Neonatal Suppurative Parotitis Caused by Escherichia coli in Korea","authors":"J. Cho, Jong Hyuk Youn, J. Park, J. Cho","doi":"10.5385/nm.2020.27.2.94","DOIUrl":"https://doi.org/10.5385/nm.2020.27.2.94","url":null,"abstract":"Neonatal acute suppurative parotitis is rare. Staphylococcus aureus is the most com mon pathogen and antibiotic treatment is the first line therapy. Here, we report a case of acute suppurative parotitis caused by Escherichia coli in a 7dayold male with febrile sensation, parotid swelling, and purulent discharge from the Stensen duct who was treated successfully with intravenous antibiotics. To the best of our knowledge, this is the first case of neonatal suppurative parotitis caused by E. coli in Korea.","PeriodicalId":32945,"journal":{"name":"Neonatal Medicine","volume":"27 1","pages":"94-98"},"PeriodicalIF":0.0,"publicationDate":"2020-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46950932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: To identify the recent status of the neonatologist and their workload in neonatal intensive care unit (NICU) in Korea. Methods: On October 2018, a survey was conducted on the statistics of the workforce including the census of certified neonatologists, NICU beds, nursing staffing ratings, bed occupancy rate, annual admission of very low birth weight infant (VLBWI), infant acuity score of nursing, and the proportion of out-born patients. The level of neonatal care was self-rated. Results: A total of 68 centers responded to the survey. An average number of cer tified neonatologists and the number of NICU beds per center was 1.9 (range, 0 to 5) and 23.1 (range, 0 to 30), respectively. Thirty-eight percent (n=26) of NICUs were being operated with only one (n=24) or no (n=2) certified neonatologist and only 19% (n=13) of NICUs had ≥3 neonatologists. The average ratio of NICU beds to neonatologists rated 13.4±6.2. The higher the level of neonatal care, the higher the number of tertiary referral hospitals, neonatologists, NICU volume, infant acuity scores of nursing, and annual VLBWI admissions. However, there was no difference in the beds to neonatologist ratio between level 2 (n=9, 9.5±3.1), level 3 (n=44, 14.0± 6.9), and level 4 (n=14, 13.7±4.2). The infant acuity score was proportional to the NICU volumes, but not related to the beds to neonatologist ratio. Conclusion: Compared with the international standards, most Korean NICUs were understaffed in terms of the certified neonatologist and were unable to provide ‘continuity of care’ for high-risk newborns.
{"title":"Current Status of Neonatologist Staffing and Workload in Korean Neonatal Intensive Care Units","authors":"B. Lee, J. Lim, Y. Choi, Ki-Soo Kim","doi":"10.5385/nm.2020.27.2.65","DOIUrl":"https://doi.org/10.5385/nm.2020.27.2.65","url":null,"abstract":"Purpose: To identify the recent status of the neonatologist and their workload in neonatal intensive care unit (NICU) in Korea. Methods: On October 2018, a survey was conducted on the statistics of the workforce including the census of certified neonatologists, NICU beds, nursing staffing ratings, bed occupancy rate, annual admission of very low birth weight infant (VLBWI), infant acuity score of nursing, and the proportion of out-born patients. The level of neonatal care was self-rated. Results: A total of 68 centers responded to the survey. An average number of cer tified neonatologists and the number of NICU beds per center was 1.9 (range, 0 to 5) and 23.1 (range, 0 to 30), respectively. Thirty-eight percent (n=26) of NICUs were being operated with only one (n=24) or no (n=2) certified neonatologist and only 19% (n=13) of NICUs had ≥3 neonatologists. The average ratio of NICU beds to neonatologists rated 13.4±6.2. The higher the level of neonatal care, the higher the number of tertiary referral hospitals, neonatologists, NICU volume, infant acuity scores of nursing, and annual VLBWI admissions. However, there was no difference in the beds to neonatologist ratio between level 2 (n=9, 9.5±3.1), level 3 (n=44, 14.0± 6.9), and level 4 (n=14, 13.7±4.2). The infant acuity score was proportional to the NICU volumes, but not related to the beds to neonatologist ratio. Conclusion: Compared with the international standards, most Korean NICUs were understaffed in terms of the certified neonatologist and were unable to provide ‘continuity of care’ for high-risk newborns.","PeriodicalId":32945,"journal":{"name":"Neonatal Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48988729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: Association between hyponatremia and the severity of respiratory symptoms in infants with respiratory syncytial virus (RSV) infection has not yet been studied. This study aimed to compare respiratory symptoms, assessed using the Pediatric Res piratory Score (PRS), in infants with RSV infection, with or without hyponatremia. Methods: RSVpositive patients aged <12 months who were admitted with respiratory symptoms within 7 days of onset at Jeonbuk National University Children’s Hospital from January 2016 to December 2019 were retrospectively analyzed. Each patient was categorized into those with or without hyponatremia (serum sodium concentration of <136 mmol/L). Clinical findings included PRS on the day of admission. Results: The mean±standard deviation age of the 125 patients included in the study was 2.7±3.3 months, and, 20 patients (16.0%) showed hyponatremia. Infants with RSV infection and hyponatremia had lower birth weights, longer hospital stays, and higher blood urea nitrogen level. The Creactive protein level was significantly higher in the hyponatremic infants, who had higher PRSs. The nonhyponatremia group had more normal PRSs than the hyponatremia group, which had more severe PRSs. After adjustment for age at admission, blood urea nitrogen level (OR, 1.218; 95% CI, 1.023 to 1.451; P<0.05), and PRS grade (OR, 2.885; 95% CI, 1.158 to 7.187; P< 0.05) were identified as independent risk factors. Conclusion: Hyponatremia was strongly associated with respiratory severity in infants with RSV. Therefore, infants admitted with RSV infection who show higher PRS grade need to be evaluated and treated for hyponatremia.
{"title":"Association between Serum Hyponatremia and Severity of Respiratory Symptoms in Infants with Respiratory Syncytial Virus Infection","authors":"Sun Oh Yum, Hyun Ho Kim, Jin Kyu Kim","doi":"10.5385/nm.2020.27.2.82","DOIUrl":"https://doi.org/10.5385/nm.2020.27.2.82","url":null,"abstract":"Purpose: Association between hyponatremia and the severity of respiratory symptoms in infants with respiratory syncytial virus (RSV) infection has not yet been studied. This study aimed to compare respiratory symptoms, assessed using the Pediatric Res piratory Score (PRS), in infants with RSV infection, with or without hyponatremia. Methods: RSVpositive patients aged <12 months who were admitted with respiratory symptoms within 7 days of onset at Jeonbuk National University Children’s Hospital from January 2016 to December 2019 were retrospectively analyzed. Each patient was categorized into those with or without hyponatremia (serum sodium concentration of <136 mmol/L). Clinical findings included PRS on the day of admission. Results: The mean±standard deviation age of the 125 patients included in the study was 2.7±3.3 months, and, 20 patients (16.0%) showed hyponatremia. Infants with RSV infection and hyponatremia had lower birth weights, longer hospital stays, and higher blood urea nitrogen level. The Creactive protein level was significantly higher in the hyponatremic infants, who had higher PRSs. The nonhyponatremia group had more normal PRSs than the hyponatremia group, which had more severe PRSs. After adjustment for age at admission, blood urea nitrogen level (OR, 1.218; 95% CI, 1.023 to 1.451; P<0.05), and PRS grade (OR, 2.885; 95% CI, 1.158 to 7.187; P< 0.05) were identified as independent risk factors. Conclusion: Hyponatremia was strongly associated with respiratory severity in infants with RSV. Therefore, infants admitted with RSV infection who show higher PRS grade need to be evaluated and treated for hyponatremia.","PeriodicalId":32945,"journal":{"name":"Neonatal Medicine","volume":"27 1","pages":"82-88"},"PeriodicalIF":0.0,"publicationDate":"2020-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44567179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: Periventricular leukomalacia (PVL) is an important morbidity in preterm infants. Its reported prevalence in very low birth weight (VLBW) infants is 3% to 15% in VLBW infants. PVL develop seizure disorder, intellectual disability, visual problem, and cerebral palsy. This study was done to describe the risk factors of PVL in VLBW infants. Methods: Medical records of 172 VLBW infants at Inje University Ilsan Paik Hospital neonatal intensive care unit were reviewed retrospectively from January 2010 to De cember 2014. Patients were divided into the nonPVL group (n=155) and the PVL group (n=17). The PVL group included both cystic and noncystic forms. Demographic findings and factors associated with PVL were compared between these groups. Results: The incidence of noncystic and cystic PVL was 9.8%. The mean gestational age was significantly lower in the PVL group. The mean birth weight was not significantly different between the groups. The incidences of premature rupture of membrane and pregnancy induced hypertension were not significantly different between the two groups. The number of histologic chorioamnionitis was significantly higher in the PVL group (P<0.05). Other conditions such as respiratory distress syndrome, patent ductus arteriosus, earlyonset sepsis, and hypotension were not significantly different between the two groups. The incidence of intravascular hemorrhage (IVH) (grade ≥3) was more significant in the PVL group (P<0.05). Multiple logistic regression analysis indicated that histologic chorioamnionitis (odds ratio [OR], 6.3; 95% confidence interval [CI], 1.1 to 36.3) and IVH (grade ≥3) (OR, 16.9; 95% CI, 1.9 to 153.1) were significant risk factors of PVL. Conclusion: Histologic chorioamnionitis and IVH (grade ≥3) increase the risk of PVL in VLBW infants. Strategies to prevent these conditions could attenuate the incidence of PVL.
{"title":"The Risk Factors of Periventricular Leukomalacia among Very Low Birth Weight Infants","authors":"H. A. Park, J. Hwang","doi":"10.5385/nm.2020.27.2.51","DOIUrl":"https://doi.org/10.5385/nm.2020.27.2.51","url":null,"abstract":"Purpose: Periventricular leukomalacia (PVL) is an important morbidity in preterm infants. Its reported prevalence in very low birth weight (VLBW) infants is 3% to 15% in VLBW infants. PVL develop seizure disorder, intellectual disability, visual problem, and cerebral palsy. This study was done to describe the risk factors of PVL in VLBW infants. Methods: Medical records of 172 VLBW infants at Inje University Ilsan Paik Hospital neonatal intensive care unit were reviewed retrospectively from January 2010 to De cember 2014. Patients were divided into the nonPVL group (n=155) and the PVL group (n=17). The PVL group included both cystic and noncystic forms. Demographic findings and factors associated with PVL were compared between these groups. Results: The incidence of noncystic and cystic PVL was 9.8%. The mean gestational age was significantly lower in the PVL group. The mean birth weight was not significantly different between the groups. The incidences of premature rupture of membrane and pregnancy induced hypertension were not significantly different between the two groups. The number of histologic chorioamnionitis was significantly higher in the PVL group (P<0.05). Other conditions such as respiratory distress syndrome, patent ductus arteriosus, earlyonset sepsis, and hypotension were not significantly different between the two groups. The incidence of intravascular hemorrhage (IVH) (grade ≥3) was more significant in the PVL group (P<0.05). Multiple logistic regression analysis indicated that histologic chorioamnionitis (odds ratio [OR], 6.3; 95% confidence interval [CI], 1.1 to 36.3) and IVH (grade ≥3) (OR, 16.9; 95% CI, 1.9 to 153.1) were significant risk factors of PVL. Conclusion: Histologic chorioamnionitis and IVH (grade ≥3) increase the risk of PVL in VLBW infants. Strategies to prevent these conditions could attenuate the incidence of PVL.","PeriodicalId":32945,"journal":{"name":"Neonatal Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48261367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Choi, Jisook Kim, S. Ahn, Y. Chang, W. Park, S. Sung
{"title":"Corrigendum: Tolerability and Effect of Early High-Dose Amino Acid Administration in Extremely Low Birth Weight Infants","authors":"J. Choi, Jisook Kim, S. Ahn, Y. Chang, W. Park, S. Sung","doi":"10.5385/nm.2020.27.1.44","DOIUrl":"https://doi.org/10.5385/nm.2020.27.1.44","url":null,"abstract":"","PeriodicalId":32945,"journal":{"name":"Neonatal Medicine","volume":"27 1","pages":"44-44"},"PeriodicalIF":0.0,"publicationDate":"2020-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42544593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Iatrogenic esophageal perforation is a rare condition in children, but occasionally occurs in premature infants due to repeated intubation or nasogastric tube insertion. Esophageal perforation is common in pneumothorax and interstitial emphysema, but rarely occurs in the absence of pneumothorax. Although complications, such as mediastinitis, after esophageal perforation are rare, they can be fatal. Therefore, rapid and accurate diagnosis and appropriate treatment are important. The authors report a case of huge retrocardiac pneumomediastinum and subcutaneous emphysema suspected to be caused by esophageal perforation after repeated intubation.
{"title":"A Case of Neonatal Pneumomediastinum with Subcutaneous Emphysema Suspected to Be Caused by Pharyngoesophageal Injury","authors":"Soo Hyun Lee, Jin Kyu Kim","doi":"10.5385/nm.2020.27.1.21","DOIUrl":"https://doi.org/10.5385/nm.2020.27.1.21","url":null,"abstract":"Iatrogenic esophageal perforation is a rare condition in children, but occasionally occurs in premature infants due to repeated intubation or nasogastric tube insertion. Esophageal perforation is common in pneumothorax and interstitial emphysema, but rarely occurs in the absence of pneumothorax. Although complications, such as mediastinitis, after esophageal perforation are rare, they can be fatal. Therefore, rapid and accurate diagnosis and appropriate treatment are important. The authors report a case of huge retrocardiac pneumomediastinum and subcutaneous emphysema suspected to be caused by esophageal perforation after repeated intubation.","PeriodicalId":32945,"journal":{"name":"Neonatal Medicine","volume":"27 1","pages":"21-25"},"PeriodicalIF":0.0,"publicationDate":"2020-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41899919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: We compared perinatal characteristics, clinical outcomes, and treatment between late preterm infants born at 34 weeks and 35 to 36 weeks of gestation. Methods: We reviewed the medical records of 254 neonates (gestational age 34 to 36 weeks) who were born at Inje University Sanggye Paik Hospital between July 1, 2013 and June 31, 2018. Late preterm infants were categorized into two groups: Group 1 (born at 34 weeks, n=88) and Group 2 (born at 35 to 36 weeks, n=162). We compared the clinical outcomes, treatment, and readmission within 12 months after birth between two groups. Results: Group 1 showed higher frequencies of antenatal steroid administration, prema ture membrane rupture, maternal antibiotic use, and histologic chorioamnionitis. Group 1 also had significantly more medical problems such as respiratory distress, feed ing intolerance, gavage feeding, neonatal jaundice, apnea or bradycardia, and hypocalcemia. Treatment during hospital stay including respiratory support, nutritional sup port, and antibiotics use over 24 hours was also significantly higher in Group 1. In addition, delayed discharge was more frequent in Group 1. Conclusion: Late preterm infants born at 34 weeks gestation had significantly higher morbidity, required more aggressive management, and more often had delayed dis charge compared to those in late preterm infants born at 35 to 36 weeks’ gestation.
{"title":"Comparison of Clinical Outcomes in Late Preterm Infants between Born at 34+0 to 34+6 Weeks and at 35+0 to 36+6 Weeks of Gestation","authors":"Hyung-Joon Joo, G. Shim, M. Chey","doi":"10.5385/nm.2020.27.1.8","DOIUrl":"https://doi.org/10.5385/nm.2020.27.1.8","url":null,"abstract":"Purpose: We compared perinatal characteristics, clinical outcomes, and treatment between late preterm infants born at 34 weeks and 35 to 36 weeks of gestation. Methods: We reviewed the medical records of 254 neonates (gestational age 34 to 36 weeks) who were born at Inje University Sanggye Paik Hospital between July 1, 2013 and June 31, 2018. Late preterm infants were categorized into two groups: Group 1 (born at 34 weeks, n=88) and Group 2 (born at 35 to 36 weeks, n=162). We compared the clinical outcomes, treatment, and readmission within 12 months after birth between two groups. Results: Group 1 showed higher frequencies of antenatal steroid administration, prema ture membrane rupture, maternal antibiotic use, and histologic chorioamnionitis. Group 1 also had significantly more medical problems such as respiratory distress, feed ing intolerance, gavage feeding, neonatal jaundice, apnea or bradycardia, and hypocalcemia. Treatment during hospital stay including respiratory support, nutritional sup port, and antibiotics use over 24 hours was also significantly higher in Group 1. In addition, delayed discharge was more frequent in Group 1. Conclusion: Late preterm infants born at 34 weeks gestation had significantly higher morbidity, required more aggressive management, and more often had delayed dis charge compared to those in late preterm infants born at 35 to 36 weeks’ gestation.","PeriodicalId":32945,"journal":{"name":"Neonatal Medicine","volume":"27 1","pages":"8-15"},"PeriodicalIF":0.0,"publicationDate":"2020-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45499648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hypophosphatasia is a rare disease characterized by defective bone mineralization due to deficiency of tissue-nonspecific alkaline phosphatase. The patient was an 8-day-old male infant who presented with seizure since that day. Other symptoms included res piratory failure, requiring the use of a mechanical ventilator. Physical exami na tion revealed a large bulging anterior fontanelle, soft skull bone, and radial devia tion of both wrists. Laboratory examination showed normal serum calcium, low para thyroid hormone, normal 25-hydroxy vitamin D, and severely low alkaline phos phatase levels. Skeletal X-ray revealed dysplasia of the skull and cupping of the epiphysis of the limbs. Two heterozygous mutations (c.1052A>G, c.1559delT) of the ALPL gene were identified by Sanger sequencing. Thus, we report a case of confirmed lethal perinatal hypophos phatasia in Korea.
{"title":"Case Report of Lethal Perinatal Hypophosphatasia with Seizure and Respiratory Failure Diagnosed by ALPL Gene Mutation","authors":"Seung Jae Lee, Dong Won Lee, W. Kim","doi":"10.5385/nm.2020.27.1.26","DOIUrl":"https://doi.org/10.5385/nm.2020.27.1.26","url":null,"abstract":"Hypophosphatasia is a rare disease characterized by defective bone mineralization due to deficiency of tissue-nonspecific alkaline phosphatase. The patient was an 8-day-old male infant who presented with seizure since that day. Other symptoms included res piratory failure, requiring the use of a mechanical ventilator. Physical exami na tion revealed a large bulging anterior fontanelle, soft skull bone, and radial devia tion of both wrists. Laboratory examination showed normal serum calcium, low para thyroid hormone, normal 25-hydroxy vitamin D, and severely low alkaline phos phatase levels. Skeletal X-ray revealed dysplasia of the skull and cupping of the epiphysis of the limbs. Two heterozygous mutations (c.1052A>G, c.1559delT) of the ALPL gene were identified by Sanger sequencing. Thus, we report a case of confirmed lethal perinatal hypophos phatasia in Korea.","PeriodicalId":32945,"journal":{"name":"Neonatal Medicine","volume":"27 1","pages":"26-30"},"PeriodicalIF":0.0,"publicationDate":"2020-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45639864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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