Outcomes in Preterm Infants ✅ Flashcards

1
Q

What outcomes should be considered in preterm infants?

A
  • Discharge from hospital
  • Key morbidities
  • Neurodevelopmental outcomes
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2
Q

What has improved the survival rates of extremely premature infants?

A
  • Use of antenatal steroids
  • Advanced ventilation techniques
  • Good intensive care
  • Decreased sepsis
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3
Q

What medical problems are extremely preterm infants at increased risk of?

A
  • Poor growth
  • Pneumonia
  • Wheezing/asthma
  • Bronchiolitis
  • Bronchopulmonary dysplasia
  • Gastro-oesophageal reflux
  • Complex nutritional and GI disorders
  • Inguinal hernias
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4
Q

What % of VLBW babies are below the 10th centile for weight, length, and head circumference at discharge?

A

Over 90%

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5
Q

What often happens to VLBW babies as they get older, with regard to growth?

A

They show some catch-up growth in the first 2-3 years

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6
Q

How is hospitalisation from RSV bronchitis reduced in VLBW babies?

A

Giving RSV monoclonal antibody - palivizumab

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7
Q

What may be required to manage bronchopulmonary dysplasia?

A

Oxygen therapy at home

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8
Q

What can cause complex nutritional and gastrointestinal disorders in premature babies?

A

NEC or GI surgery

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9
Q

What is required to manage inguinal hernias in preterm babies?

A

Surgical repair

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10
Q

How much does extreme prematurity increase the risk of readmission to hospital?

A

4x

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11
Q

What are the most common reasons for readmission to hospital in extremely premature babies?

A
  • Respiratory disorders

- Surgical repair of inguinal hernia

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12
Q

What % of VLBW infants develop cerebral palsy?

A

5-10%

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13
Q

What are the most common neurological impairments in VLBW infants?

A

Learning difficulties

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14
Q

How does gestational age affect the prevalence of cognitive impairment and other associated difficulties?

A

Prevalence increases with decreasing gestational age at birth, and is greatest if born at a very early gestational age (<26 weeks)

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15
Q

When does cognitive impairment associated with prematurity become increasingly evidence?

A

When compared to peers at nursery or school

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16
Q

What aspects of development might extremely premature infants have difficulty with?

A
  • Fine motor skills
  • Concentration, with short attention span
  • Behaviour, especially attention deficit disorders
  • Abstract reasoning
  • Processing several tasks simultaneously
17
Q

What % of extremely premature infants will require hearing amplification?

A

1-2%

18
Q

What visual impairments may VLBW infants be affected by?

A
  • Blindness
  • Refraction errors
  • Squints
19
Q

What % of extremely premature infants will be blind in both eyes?

A

1%

20
Q

What is the survival rate at 22 weeks gestation?

A

2%

21
Q

What is the survival rate at 23 weeks gestation?

A

19%

22
Q

What is the survival rate at 24 weeks gestation?

A

40%

23
Q

What is the survival rate at 25 weeks gestation?

A

66%

24
Q

What is the survival rate at 26 weeks gestation?

A

77%