Morbidity and Mortality in Newborns Flashcards
Which race has the highest infant mortality in the U.S.?
African Americans
Rank U.S. races in order of infant mortality (high > low).
African American (11/1000), Native American (8/1000), Caucasian (5/1000), Asian/Pacific Islander (4/1000).
What maternal factors correspond with higher neonatal mortality?
Late/no prenatal care, maternal age <15 years or >40 years, underlying disease, being single, smoking
What are the major factors associated with neonatal mortality?
Race, maternal factors, sex, multiple births, preterm infants, IUGR, congenital malformation
Which sex has higher neonatal mortality rates?
Males
What is the most significant risk factor for preterm delivery?
Previous preterm delivery.
What are some of the (22) known risk factors for premature birth?
Prior preterm birth (most significant risk factor, inadequate prenatal care, previous abortion, short interpregnancy interval, assisted reproduction, placental bleeding, fetal distress, erythroblastosis, nonimmune hydrops, uterine abnormalities, tobacco use, substance abuse (especially cocaine), maternal chronic disease, preeclampsia, PROM, chorioamnionitis, bacterial vaginosis, congenital anomalies, polyhydramnios, oligohydramnios, GBS, STIs.
For preterm infants, what independent risk factors correspond with increased mortality?
male sex, 5-minute Apgar score <4, lack of antenatal steroids, persistent bradycardia at 5 minutes, hypothermia, IUGR
What is the leading cause of infant death in the U.S.?
Congenital malformation (accounts for ~20% of infant mortality)
What are the most common factors contributing to IUGR?
ischemic placental disease, placental abnormalities, maternal HTN, uterine malformations, vascular disease due to DM, malnutrition, smoking, alcohol use, substance abuse.
Live birth
The complete expulsion or extraction from the mother of a living product of human conception, regardless of gestational age.
Gestational age
the number of weeks in a pregnancy since the 1st day of the last normal menstrual period
Chronological age
the age of the infant based on time after birth (postnatal age)
Corrected gestational age
the age of the infant based on expected date of delivery
Appropriate for gestational age
an infant with birth weight between 10th and 90th percentiles for given gestational age
Small for gestational age
infant with birth weight <10th percentile for the given gestational age
Large for gestational age
infant with birth weight >90th percentile for given gestational age
Low birth weight
an infant whose birth weight is <2,500g, regardless of gestational age
Very low birth weight
an infant whose birth weight is <1,500g, regardless of gestational age
Extremely low birth weight
an infant whose birth weight is <1,000g, regardless of gestational age
Preterm
an infant born before the last day of the 37th week of gestation
Term
an infant born between 38 0/7w and 42 6/7w gestation
Postterm
an infant born on or after 43 0/7w gestation
Fetal death
This is the opposite of live birth. It refers to the death of the infant before it is fully expelled or extracted from the mother.
Infant death
A death that occurs at any time from birth up to, but not including, one year of age.
Perinatal death
A death occurring between the 28th week of gestation and the 28th day of life.
Infant mortality rate
Expressed as the number of deaths per 1,000 live births.
IUGR
fetal weight <10th percentile for gestational age
