Clinical Study of 31 Polydactyly Cases Admitted to Neonatal Intensive Care Unit

Yongwook Lee; Mihyeon Gang; Meayoung Chang; Wungjoo Song; Sookza Kim

doi:10.14734/PN.2019.30.3.147

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Lee, Gang, Chang, Song, and Kim: Clinical Study of 31 Polydactyly Cases Admitted to Neonatal Intensive Care Unit

Original Article

Perinatology 2019; 30(3): 147-153.

Published online: 30 September 2019

DOI: https://doi.org/10.14734/PN.2019.30.3.147

Clinical Study of 31 Polydactyly Cases Admitted to Neonatal Intensive Care Unit

Yongwook Lee, MD¹, Mihyeon Gang, MD¹, Meayoung Chang, MD, PhD¹, Wungjoo Song, MS², Sookza Kim, MD, PhD^1,²

¹Department of Pediatrics, Chungnam National University Hospital, Daejeon, Korea.

²Korea Genetics Research Center, Cheongju, Korea.

Correspondence to Sookza Kim, MD, PhD. Korea Genetics Research Center, 745 Jikji-daero, Heungdeok-gu, Cheongju 28470, Korea. Tel: +82-43-263-8280, Fax: +82-43-215-8288, kimgenee@cnuh.co.kr

Received 16 April 2019 Revised 20 May 2019 Accepted 28 May 2019

The Korean Society of Perinatology

(open-access, http://creativecommons.org/licenses/by-nc/4.0/):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective

To investigate polydactyly in neonates who were admitted to neonatal intensive care unit (NICU) due to urgent medical needs.

Methods

Retrospective chart review of polydactyly neonates admitted to NICU of Chungnam National University Hospital between September 1997 and September 2018 was carried out. Patient data, type of polydactyly accompanying anomalies, genetic testing and clinical follow-up after discharge were reviewed and analyzed.

Results

Thirty-one neonates with polydactyly were admitted to NICU during the selected period. 61.3% were male. Most were admitted for the evaluation and treatment for other congenital anomalies. Ten neonates (32%) were small for gestational age. The most frequently observed forms of polydactyly were preaxial hand polydactyly and postaxial foot polydactyly. Cardiac anomalies (35%) were more frequent in the population than genitourinary tract anomalies (22%), central nervous system anomalies (22%), gastrointestinal tract anomalies (19%) and congenital hypothyroidism. Four neonates showed abnormal genetic finding. Three neonates were diagnosed syndromic disorder after discharge (CATCH22 syndrome, VACTERL association, Joubert syndrome). Pregnancy of these neonates was complicated by maternal diabetes (13%), hepatitis B virus (6%), exposure to herbal medicine or smoking (6%), pre-eclampsia and hypertension. Only one case in the study had positive family history for polydactyly.

Conclusion

Polydactyly could serve as a clue to syndromes and genetic disorders if associated with multiple major organ anomalies.

Keywords: Newborn, Polydactyly, Anomaly

Figures and Tables

Fig. 1

Patient number of polydactyly at neonatal intensive care unit for 21 years.

Table 1

Reason for Admission at NICU

Values are presented as number of patient.

Abbreviations: NICU, neonatal intensive care unit; CNS, central nervous system.

^*Multiple polydactyly or polydactyly with odd-looking appearance.

Table 2

Characteristics of Polydactyly Patient with Major Associated Anomalies

Abbreviations: CHD, congenital heart disease; CNS, central nervous system; GUT, genitourinary tract; GIT, gastrointestinal tractens; ASD, atrial septal defect; -, absent; VSD, ventricular septal defect; TOF, tetralogy of fallot; SUA, single umbilical artery; AVV atrioventricular valve; PDA, patent ductus arteriosus; ARM, anorectal malformation; DORV, double outlet right ventricle; MCDK, multicystic dysplastic kidney.

Table 3

Associated Anomalies according to Polydactyly Classification

Abbreviations: VSD, ventricular septal defect; ASD, atrial septal defect; TOF, tetralogy of fallot; AVV atrioventricular valve; DORV, double outlet right ventricle; PDA, patent ductus arteriosus; MCDK, multicystic dysplastic kidney; ARM, anorectal malformation.

Table 4

Associated Anomalies according to Maternal Factor

Abbreviations: HBV, hepatits B virus; VSD, ventricular septal defect; ASD, atrial septal defect; AVV atrioventricular valve; ARM, anorectal malformation; PDA, patent ductus arteriosus; DM, diabetic mellitus; MCDK, multicystic dysplastic kidney; HTN, hypertension.

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