general 1 Flashcards
list risk factors for babies born to adolescent mothers
at greater risk for low birth weight…
- lower birth weight
- vertically acquired STIs (due to higher incidence of STIs in adolescent population)
- poorer developmental outcomes
- increased risk of fetal death
**infants born to adolescent mothers DO NOT have increased incidence of chromosomal abnormalities; trisomy 21 is more likely in older mothers
what are the risks of tobacco use in pregnancy
maternal tobacco use increases risk for low birth weight in the fetus
NO characteristic facies associated
is there any safe amount of alcohol in pregnancy
no–always risk of FAS
what is FAS
distinct pattern of facial abnormalities, growth deficiency and evidence of CNS dysfunction
in addition to cognitive disability, victims of fetal alcohol syndrome exhibit other neurobehavioral deficits such as poor motor skills and hand-eye coordination and learning problems (difficulties with memory, attention and judgement)
have distinctive effects of marijuana on the fetus been identified
no
what is the effect of cocaine use on the fetus
causes vasoconstriction leading to placental insufficiency and low birth weight
may lead to subtle yet significant later deficits in some kids including in cognitive performance, information processing and attention tasks
list maternal factors that limit fetal growth in utero
- poor weight gain in the third trimester
- preeclampsia
- maternal prescription or illicit drug use
- maternal infections
- uterine abnormalities
list placental factors that limit fetal growth in utero
- placenta previa
- placental abruptions
- abnormal umbilical vessel insertions
list fetal factors that limit fetal growth in utero
- fetal malformations
- metabolic disease
- chromosomal abnormalities
- congenital infections
what does it mean for an infant to be SGA
newborns noted to be smaller than expected for their gestational age
not synonymous but often used interchangeably with–
fetal growth restriction
IUGR
intrauterine growth retardation
list factors that increase the risk of transmission of HIV from mother to infant
- frequent unprotected sex during pregnancy (increases risk of chorioamnionitis which, along with other STIs, increase risk of HIV transmission)
- advanced HIV maternal disease (may indicate high viral load)
- membrane rupture greater than 4 hours prior to delivery if mother not on ARVs
- vaginal delivery
- breastfeeding
- premature delivery (before 37 weeks GA)
what are the components of the APGAR score
Appearance (skin color) Pulse (HR) Grimace (reflex irritability) Activity (muscle tone) Respiration
score of 0, 1 or 2 for each component with final score ranging from 0-10
define SGA
weight below the 10th percentile for GA
define microcephalic
head circumference below 10th percentile for GA
what is a term infant
born at more than 37 weeks GA
describe the Ballard gestational age assessment tool
uses signs of physical and neuromuscular maturity to estimate gestational age
can be helpful if there is no early US to help date the pregnancy or if the GA is in questions because of uncertain maternal dates
list the risks that face SGA newborns
- hypoglycemia
- hypothermia
- polycythemia
why are SGA infants at risk for hypoglycemia and what are the symptoms
happens because-- decreased glycogen stores heat loss possible hypoxia decreased gluconeogenesis
commonly asymptomatic, though may exhibit poor feeding and listlessness
why are SGA infants at risk for hypothermia and what are the symptoms
happens because-- cold stress hypoxia hypoglycemia increased surface area decreased subQ insulation
commonly asymptomatic, though may exhibit poor feeding and listlessness
why are SGA infants at risk for polycythemia and what are the symptoms
happens because–
chronic hypoxia
maternal-fetal transfusion
“ruddy” or red color to skin, respiratory distress, poor feeding, hypoglycemia
*infants with slugging blood flow (hyperviscosity) because of a critically elevated Hb/Hct may have resp distress secondary to inadequate oxygenation of end organ tissues
what are TORCH infections
refers to prenatal or congenital infections
Toxoplasmosis
Rubella
CMV
HSV2
now also… HIV, Hep B, human parvovirus, syphilis
what would you expect to see on brain imaging in an infant with congenital CMV
- intracranial calcifications (appear as bright areas on CT)
- diminished number of gyri and abnormally thick cortex (lissencephaly/agyria-pachygyria)
- enlarged ventricles
what does congenital CMV cause?
- hearing loss(–>onset of hearing loss may be after newborn period, often progressive)
- microcephaly and intracranial calcifications(–> developmental delay, cerebreal palsy; require ongoing developmental assessment)
- hepatosplenomegaly(–> can be expected to resolve spontaneously within a few weeks)
- rash
what feeding is recommended for premature infants
breastmilk plus fortifier