OUT SIZED BABY Flashcards
Outsized babies are babies with ___________________ than expected weights at birth based on a standard weight cut off
<________ (LBW) ≥__________ ( Macrosomic)
bigger or smaller
2500g; 4000g
Low birth weight
Low birth weight is a term used to describe babies who are born weighing less than _________ grams regardless of gestational age.
This is based on epidemiological observations that infants weighing less than _______ g are approximately _____ times more likely to ______ than heavier babies.
2,500 grams
2,500 g ; 20 times
die
Sub-classification of low birth weight :
very low birth weight (VLBW), which is less than ______g
extremely low birth weight (ELBW), which is less than _______ g
1500
1000
Causes of LBW
The primary cause of low birthweight is ______________ (being born before ____ weeks gestation).
Another cause of low birthweight is ___________________________. This occurs when a baby does not grow well during pregnancy because of problems with the __________ , the _______ _______ , or the _________ condition.
premature birth ; 37
intrauterine growth restriction (IUGR).
placenta ; mother’s health ; baby’s
A baby can have IUGR and be born at full term
T/F
T
Risk factors for LBW
Any baby born prematurely is more likely to be very small. However, there are other factors that can also contribute to the risk of low birthweight. These include:
Race: ____________ babies are two times more likely to have low birthweight than _______ babies.
Age:______ mothers (especially those younger than ______ years old) have a much higher risk of having a baby with low birthweight.
Multiple birth: Multiple birth babies are at increased risk for low birthweight because _______________ . Over half of twins and other multiples have low birthweight.
African-American; white
Teen; 17
they often are premature
Risk factors for LBW
Mother’s health: Babies of mothers who are exposed to ______,_______,____________ are more likely to have low birthweight.
Mothers of ________ socioeconomic status are also more likely to have poorer pregnancy nutrition, inadequate prenatal care, and pregnancy complications- -all factors that can contribute to low birthweight.
illicit drugs, alcohol, and cigarettes
lower
Problems of LBW
The following are some of the common problems of low birthweight babies:
•___________ at birth
•Inability to maintain _______________
•Difficulty _________ and _________
•Infection
•Breathing problems, such as infant __________________________ (a respiratory disease of prematurity caused by immature lungs)
•Neurologic problems, such as _________________e (bleeding inside the brain)
•Gastrointestinal problems, such as _______________________ (a serious disease of the intestine common in premature babies)
•____________________ syndrome (SIDS)
Asphyxia ; body temperature
feeding ; gaining weight
infant respiratory distress syndrome
intraventricular hemorrhage
necrotizing enterocolitis
Sudden infant death syndrome (SIDS)
Diagnosis of LBW
During pregnancy, a baby’s birthweight can be estimated in different ways.
Measurement of _________________
Use of ________ with which measurements can be taken of the fetus’ head, abdomen, and femur and compared with a growth chart to estimate fetal weight.
fundal height
USS
Babies are weighed within the ____________ after birth.
The weight is compared with the baby’s _______________ and recorded in the medical record ( LBW, VLBW or ELBW)
first few hours
gestational age
LBW babies are further classified using centile charts into:
___________
___________
___________
AGA
SGA
LGA
SGA babies are further classified into
____________ and ________ IUGR using the _______________
Symmetrical; asymmetrical
Ponderal Index
Ponderal Index
PI = _________ (g) / ________ [3] (cm) X 100 .
<_____= ____________ IUGR;
>_____ = _____________ IUGR
weight
length
2.1 ; Symmetrical
2.1 ; Asymmetric
Treatment for LBW
Survival of infants with low birthweight depends largely on how much the baby weighs at birth, with the smallest babies (<__________ grams) having the lowest survival rate.
Care for low birthweight babies often includes: Care in the _________
__________ controlled beds /_________
Special feedings, sometimes with a tube into the stomach if a baby cannot suck, or through an intravenous (IV) line
Other treatments for complications eg for sepsis, NNJ, RDS, etc
Low birthweight babies typically “catch up” in physical growth if there are no other complications
500 ; NICU
Temperature ; incubators
Macrosomia
The term macrosomia is used to describe a newborn with an ______________________.
A diagnosis of fetal macrosomia can be made only by measuring ________________________________
excessive birth weight.
birth weight after delivery
Fetal macrosomia has been defined as birth weight of ≥ _______g or greater than ______% for gestational age.
4000
90
Epidemiology of Macrosomia
Fetal macrosomia is encountered in up to ______% of deliveries
(Male or Female?) infants are more likely to be macrosomic than (male or female?) infants.
Commoner in ___________ race
10%
Male ; female
Caucasians
The pathophysiology of macrosomia is related to the associated maternal or fetal condition that accounts for its development
____________ in the fetus results in the stimulation of __________,__________,_______________, and other growth factors, which, in turn, stimulate fetal growth and deposition of ________ and ______________.
___________ gestational age results in a larger birth weight at delivery by allowing the growth process to continue in utero.
Hyperglycemia
insulin ; insulin-like growth factors ; growth hormone
fat ; glycogen
Advanced
Causes
Fetal macrosomia can be caused by genetic factors as well as maternal conditions, such as __________ or ____________.
Rarely, a baby might have a medical condition that speeds fetal growth eg _____________________ syndrome, __________ syndrome.
In some cases, what causes a larger than average birth weight remains unexplained
obesity or diabetes
Beckwith- Wiedemann
Sotos
Risk Factors for Fetal Macrosomia
• Maternal _____________
• Maternal impaired _______________
•________-parity
• Previous ________________
•Excessive ___________
•(Male or Female?( fetus
•Parental stature
•Prolonged ___________
•Maternal ____________
diabetes ; glucose intolerance
Multi; macrosomic infant
weight gain; male
gestation; obesity
Consequences of Fetal macrosomia
The delivery of a macrosomic infant has potentially serious consequences for the infant and the mother.
The most feared result of macrosomia is ______________ , and up to one fourth of infants with this ,experience _________ or ____________ injuries, or fractures of the ________ or _________ and asphyxia
shoulder dystocia
brachial plexus ; facial nerve
humerus ; clavicle
Consequences of Fetal macrosomia
Neonatal risks associated with macrosomia include ___________ (50% independent of whether the mother has diabetes.), hematological disturbances (ie, _____________), and electrolyte disturbances (up to 50%).
The mother is at increased risk for _____________
Vaginal delivery of a macrosomic infant increases the risk of __________ or _________ -degree _________ fivefold in mother.
hypoglycemia ; polycythemia
cesarean section
third- or fourth-
lacerations
Diagnosis of macrosomia
It’s important to note that LGA and macrosomia cannot be diagnosed until ___________, as it is impossible to accurately estimate the size and weight of a child in the womb
Babies that are large for gestational age throughout the pregnancy may be suspected because of an ultrasound.
Fetal growth charts are used to diagnose macrosomia at birth.
after birth
Treatment of macrosomia
Treatment includes _______ management of the pregnancy
Control maternal ___________
_____________ to minimize birth trauma
Monitor neonate and treat for __________, ___________ and ___________
proactive; diabetes
Caesarian section
hypoglycaemia ; polycythemia
NNJ
