Outcomes in Preterm Infants ✅ Flashcards
What outcomes should be considered in preterm infants?
- Discharge from hospital
- Key morbidities
- Neurodevelopmental outcomes
What has improved the survival rates of extremely premature infants?
- Use of antenatal steroids
- Advanced ventilation techniques
- Good intensive care
- Decreased sepsis
What medical problems are extremely preterm infants at increased risk of?
- Poor growth
- Pneumonia
- Wheezing/asthma
- Bronchiolitis
- Bronchopulmonary dysplasia
- Gastro-oesophageal reflux
- Complex nutritional and GI disorders
- Inguinal hernias
What % of VLBW babies are below the 10th centile for weight, length, and head circumference at discharge?
Over 90%
What often happens to VLBW babies as they get older, with regard to growth?
They show some catch-up growth in the first 2-3 years
How is hospitalisation from RSV bronchitis reduced in VLBW babies?
Giving RSV monoclonal antibody - palivizumab
What may be required to manage bronchopulmonary dysplasia?
Oxygen therapy at home
What can cause complex nutritional and gastrointestinal disorders in premature babies?
NEC or GI surgery
What is required to manage inguinal hernias in preterm babies?
Surgical repair
How much does extreme prematurity increase the risk of readmission to hospital?
4x
What are the most common reasons for readmission to hospital in extremely premature babies?
- Respiratory disorders
- Surgical repair of inguinal hernia
What % of VLBW infants develop cerebral palsy?
5-10%
What are the most common neurological impairments in VLBW infants?
Learning difficulties
How does gestational age affect the prevalence of cognitive impairment and other associated difficulties?
Prevalence increases with decreasing gestational age at birth, and is greatest if born at a very early gestational age (<26 weeks)
When does cognitive impairment associated with prematurity become increasingly evidence?
When compared to peers at nursery or school
What aspects of development might extremely premature infants have difficulty with?
- Fine motor skills
- Concentration, with short attention span
- Behaviour, especially attention deficit disorders
- Abstract reasoning
- Processing several tasks simultaneously
What % of extremely premature infants will require hearing amplification?
1-2%
What visual impairments may VLBW infants be affected by?
- Blindness
- Refraction errors
- Squints
What % of extremely premature infants will be blind in both eyes?
1%
What is the survival rate at 22 weeks gestation?
2%
What is the survival rate at 23 weeks gestation?
19%
What is the survival rate at 24 weeks gestation?
40%
What is the survival rate at 25 weeks gestation?
66%
What is the survival rate at 26 weeks gestation?
77%
