238. Prematurity

Question 1

What is defined as an infant born before 37 weeks of gestation?

Answer 1

Prematurity

Preterm infants are often classified by birthweight.

Question 2

What is the birthweight classification for very low birthweight infants?

Answer 2

Below 1500 g

Preterm birth is associated with significant risks including infant mortality and cerebral palsy.

Question 3

What percentage of infant mortality is associated with preterm birth?

Answer 3

30%

Preterm birth also contributes to 45% of cerebral palsy cases.

Question 4

What is the gestational age cutoff for extremely preterm infants?

Answer 4

Before 25 weeks’ gestation

Extremely preterm infants are at the greatest risk for complications.

Question 5

List some prevalent complications associated with premature infants.

Answer 5

• Respiratory complications
• Retinal complications
• Gastrointestinal complications
• Cardiovascular complications
• Infectious complications
• Neurodevelopmental disabilities

These complications can be both short-term and chronic.

Question 6

What is respiratory distress syndrome (RDS) a result of?

Answer 6

Decreased surfactant production

Surfactant increases lung compliance and aids gas exchange.

Question 7

What are some symptoms of respiratory distress syndrome (RDS)?

Answer 7

• Hypoxemia
• Tachypnea
• Hypercarbia
• Acidosis

The severity of RDS is inversely related to gestational age.

Question 8

What therapy should be administered to pregnant women at 23 to 34 weeks’ gestation with increased risk of preterm delivery?

Answer 8

Antenatal corticosteroid therapy

This therapy helps improve outcomes for preterm infants.

Question 9

What is bronchopulmonary dysplasia (BPD) defined as?

Answer 9

The need for supplemental oxygen at 36 weeks’ postmenstrual age

BPD affects approximately 30% of extremely low birthweight infants.

Question 10

What increases the risk of developing bronchopulmonary dysplasia (BPD) in preterm infants?

Answer 10

• Ventilatory support
• Infections

These factors can cause mechanical injury, oxidative stress, and inflammation.

Question 11

What percentage of very low birthweight infants experience bacterial infections leading to sepsis?

Answer 11

Approximately 25%

Preterm infants are immunocompromised due to underdeveloped immune systems.

Question 12

What is necrotizing enterocolitis (NEC) characterized by?

Answer 12

Serious gastrointestinal complications

Symptoms include feeding intolerance and distention.

Question 13

What are the potential sequelae of necrotizing enterocolitis (NEC)?

Answer 13

• Intestinal strictures
• Short-bowel syndrome
• Feeding intolerance

Severe cases may require surgical intervention.

Question 14

What are periventricular leukomalacia (PVL) and intraventricular hemorrhage (IVH) primarily associated with?

Answer 14

Perinatal brain injuries in premature infants

PVL leads to cerebral palsy due to systemic inflammation and ischemic attack.

Question 15

What is intraventricular hemorrhage (IVH) defined as?

Answer 15

Bleeding within the ventricles that may extend into the surrounding parenchyma

IVH has a significant mortality rate and can lead to long-term complications.

Question 16

What does retinopathy of prematurity (ROP) involve?

Answer 16

Abnormal vascular proliferation within the retina

ROP can lead to severe visual impairments and potentially blindness.

Question 17

What has contributed to a decrease in the incidence of retinopathy of prematurity (ROP) in developed countries?

Answer 17

Decreased oxygen administration

ROP affects approximately 50,000 infants worldwide each year.

Question 18

What approach has reduced mortality from acute respiratory distress syndrome (RDS) in premature infants?

Answer 18

Prompt steroid administration paired with surfactant therapy

This has increased survival rates but also BPD incidences.

Question 19

What is the challenge with temperature regulation in premature infants?

Answer 19

Relatively thin epidermis and increased fluid loss

The body surface area to weight ratio increases thermal conductance and heat loss.

Question 20

What is the preferred method for postoperative pain management in infants?

Answer 20

Multimodal approach utilizing local anesthetics and nerve block techniques

Systemic nonsteroidal anti-inflammatory drugs and acetaminophen are preferred over opioids.

Question 21

True or False: Sedatives are routinely utilized in premature infants.

Answer 21

False

Distraction techniques are preferred due to risks associated with sedatives.

Question 22

Fill in the blank: The severity of respiratory distress syndrome (RDS) is _______ related to gestational age.

Answer 22

inversely

Lower gestational age correlates with greater severity of RDS.