Morbidity and Mortality in Newborns

Question 1

Which race has the highest infant mortality in the U.S.?

Answer 1

African Americans

Question 2

Rank U.S. races in order of infant mortality (high > low).

Answer 2

African American (11/1000), Native American (8/1000), Caucasian (5/1000), Asian/Pacific Islander (4/1000).

Question 3

What maternal factors correspond with higher neonatal mortality?

Answer 3

Late/no prenatal care, maternal age <15 years or >40 years, underlying disease, being single, smoking

Question 4

What are the major factors associated with neonatal mortality?

Answer 4

Race, maternal factors, sex, multiple births, preterm infants, IUGR, congenital malformation

Question 5

Which sex has higher neonatal mortality rates?

Answer 5

Males

Question 6

What is the most significant risk factor for preterm delivery?

Answer 6

Previous preterm delivery.

Question 7

What are some of the (22) known risk factors for premature birth?

Answer 7

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.

Question 8

For preterm infants, what independent risk factors correspond with increased mortality?

Answer 8

male sex, 5-minute Apgar score <4, lack of antenatal steroids, persistent bradycardia at 5 minutes, hypothermia, IUGR

Question 9

What is the leading cause of infant death in the U.S.?

Answer 9

Congenital malformation (accounts for ~20% of infant mortality)

Question 10

What are the most common factors contributing to IUGR?

Answer 10

ischemic placental disease, placental abnormalities, maternal HTN, uterine malformations, vascular disease due to DM, malnutrition, smoking, alcohol use, substance abuse.

Question 11

Live birth

Answer 11

The complete expulsion or extraction from the mother of a living product of human conception, regardless of gestational age.

Question 12

Gestational age

Answer 12

the number of weeks in a pregnancy since the 1st day of the last normal menstrual period

Question 13

Chronological age

Answer 13

the age of the infant based on time after birth (postnatal age)

Question 14

Corrected gestational age

Answer 14

the age of the infant based on expected date of delivery

Question 15

Appropriate for gestational age

Answer 15

an infant with birth weight between 10th and 90th percentiles for given gestational age

Question 16

Small for gestational age

Answer 16

infant with birth weight <10th percentile for the given gestational age

Question 17

Large for gestational age

Answer 17

infant with birth weight >90th percentile for given gestational age

Question 18

Low birth weight

Answer 18

an infant whose birth weight is <2,500g, regardless of gestational age

Question 19

Very low birth weight

Answer 19

an infant whose birth weight is <1,500g, regardless of gestational age

Question 20

Extremely low birth weight

Answer 20

an infant whose birth weight is <1,000g, regardless of gestational age

Question 21

Preterm

Answer 21

an infant born before the last day of the 37th week of gestation

Question 22

Term

Answer 22

an infant born between 38 0/7w and 42 6/7w gestation

Question 23

Postterm

Answer 23

an infant born on or after 43 0/7w gestation

Question 24

Fetal death

Answer 24

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.

Question 25

Infant death

Answer 25

A death that occurs at any time from birth up to, but not including, one year of age.

Question 26

Perinatal death

Answer 26

A death occurring between the 28th week of gestation and the 28th day of life.

Question 27

Infant mortality rate

Answer 27

Expressed as the number of deaths per 1,000 live births.

Question 28

IUGR

Answer 28

fetal weight <10th percentile for gestational age