출생체중 6.14 kg의 초거대아 1예 보고
An Extremely Macrosomia Born Weighted 6.14 kg: Case Report and Review of the Literatures
0
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
신생아에서 출생체중별 구분에서 4.0 kg 이상을 과체중출생아(high birth weight infant, HBWI) 라고 한다. HBWI는 거대아112 KA Jeong, et al. • A Case of Macrosomia of Birth Weight 6.14 kg (macrosomi)와 같이 사용되는데, macrosom는 출생체중 4.0 혹은4.5 kg 이상을 칭한다. macrosomia에서는 여러 질환이 이환 될 수있기 때문에 고위험신생아군에 속하며, 집중치료가 필요한 경우가많다. 저자들은 임신나이 38주 5일에 출생체중 6.14 kg로 태어난 초거대아 1례를 경험하였기에 최근 보고하는 바이다. 환아는 임신성당뇨 모체로부터 제왕절개로 출생한 여아로 출생 후부터 시작된 빈호흡으로 입원하였다. 동반된 질환은 저혈당, 저칼슘혈증, 이차심방결손, 동맥관개존, 폐동맥고혈압 등 이었다. 대증요법으로 호전되어입원 10일에 증상 호전되어 퇴원하였고, 출생 후 6개월까지 외래 추적 관찰 중에서 특이 문제는 없다. 저자들은 이번 초거대아 증례의경험을 기회로, 한국통계청의 2000-2010년 출생 통계의 원시자료를통해서 총 출생아 중에서 HBWI의 빈도와 추이를 살펴보았다. 또한1964-2011년까지 한국에서 보고된 각종 macrosomia에 대한 보고들을 분석해본 결과, 동기간에 출생체중이 6.0 kg이 상인 경우는 본증례를 포함해서 7례였는데, 이중에서 본 증례는 5번째로 큰 증례이었다. 저자들은 향후 신생아분야의 고위험군 중의 하나인 거대라 관리에 도움을 주고자 관련 문헌고찰과 함께 본 증례를 보고하는 바이다.
Abstract
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+5weeks, 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.
참고문헌 (30)
- "Large for gestational age"[URL]
- Park HS, "A case of a giant baby whose weight at birth was 8.8 kg", Korean J Obstet Gynecol, 12, pp.541~543 (1969)
- Kim YT, "One case of giant baby", Korean J Obstet Gynecol, 27, pp.411~414 (1984)
- Statistics Korea, "Birth Data in 2000-2009 (raw data from Statistics Korea)", ~
- Pak HS, "A case report of giant baby", Korean J Obstet Gynecol, 27, pp.31~33 (1984)
- Lee NH, "Clinical survey of large fetuses", Korean J Obstet Gynecol, 19, pp.109~118 (1976)
- Park EH, "A clinical survey of large babies", Korean J Obstet Gynecol, 19, pp.405~410 (1976)
- Lee JH, "Clinical survey of giant babies", Korean J Obstet Gynecol, 14, pp.81~88 (1971)
- Chung YC, "Obstetric risk of large fetus", Korean J Obstet Gynecol, 15, pp.445~451 (1972)
- Lim KJ, "A clinical study of the macrosomia", Korean J Obstet Gynecol, 26, pp.143~148 (1983)
- Yoo MS, "Clinical survey and obstetric significance of giant baby", Korean J Obstet Gynecol, 25, pp.157~164 (1982)
- Park JM, "Obstetric implications of fetal macrosomia", Korean J Obstet Gynecol, 27, pp.1257~1266 (1984)
- Ahn JJ, "A clinical survey on large infants", Korean J Obstet Gynecol, 27, pp.1660~1667 (1984)
- Kim DS, "Clinical study of macrosomia", Korean J Obstet Gynecol, 28, pp.1613~1619 (1985)
- Ha HR, "A clinical study on large babies", Korean J Obstet Gynecol, 31, pp.100~106 (1988)
- Hong KW, "Clinical survey of fatal macrosomia", Korean J Obstet Gynecol, 31, pp.925~933 (1988)
- Kang IG, "Clinical survey of fetal macrosomia", Korean J Obstet Gynecol, 34, pp.941~947 (1991)
- Yoon HK, "Clinical survey on macrosomia", Korean J Obstet Gynecol, 36, pp.150~156 (1993)
- Lee JS, "Clinical survey on fetal macrosomia", Korean J Obstet Gynecol, 37, pp.650~656 (1994)
- Kim JI, "Clinical survey of fetal macrosomia", Korean J Obstet Gynecol, 37, pp.1186~1193 (1994)
- 김도균, "거대아에 대한 임상적 고찰", Obstetrics & Gynecology Science, 47(9), pp.1668~1672 (2004), 대한산부인과학회
- Han CH, "A clinical study on macrosomia", Korean J Obstet Gynecol, 48, pp.36~41 (2005)
- Park SH, "Study on macrosomia based on birth certificate data", Korean J Obstet Gynecol, 43, pp.1611~1615 (2000)
- "Birth statistics"[URL]
- Cho AR, "Risk factors of gestational diabets mellitus", Korean J Perinatol, 18, pp.329~337 (2007)
- Hwang JS, "Neonate born to diabetic mother", Korean J Perinatol, 17, pp.241~246 (2006)
- Byung-Ho Kang, "Birth statistics of high birth weight infants (macrosomia) in Korea", Korean Journal of Pediatrics, 55(8), pp.280~285 (2012), 대한소아과학회
- 강효정, "임신성 당뇨 A1형과 A2형의 치료 후 임신 결과 및 신생아 예후 비교", Obstetrics & Gynecology Science, 53(08), pp.681~686 (2010), 대한산부인과학회
- Hur Y, "Clinical characteristics and pregnancy outcome in Korean women with type I & type II diabetes mellitus", J Korean Diabetes Assoc, 22, pp.353~362 (1998)
- 황병철, "당뇨합병임신과 비당뇨임신에서 재태기간에 따른 출생체중의 비교", Obstetrics & Gynecology Science, 53(12), pp.1078~1084 (2010), 대한산부인과학회