Pre-Term Birth

Question 1

Why do we give corticosteroids in pre-term birth

Answer 1

• Accelerate lung maturation, including the development of type 2 pneumocytes
• These produce surfactant, thus improving alveolar gas exchange in the fetal lungs

Question 2

What drug is given to reduce the risk of neurological impairment in pre-term births? What else is this given in the setting of?

Answer 2

• Magensium sulphate
• This is also given in the setting of pre-eclampsia to reduce maternal seizuresq

Question 3

How do we dose magnesium sulphate for planned pre-term births

Answer 3

• Initial loading dose
• Hourly maintenance dose for 24 hours after that

Question 4

Chorioamnionitis is a known cause of pre-term birth. What are possible complications in this setting?

Answer 4

• Cerebral palsy
• Necrotizing disorders of the GI tract (enterocolitis)
• Transient hypothyroxinaemia

(CNT -> makes sense :))

Question 5

In what setting are pre-term birth antibiotics indicated?

Answer 5

Pre-term rupture of membrane (meaning water is broken; amniotic sac is ruptured).

Question 6

Complications of pre-term birth in general? How can these translate into longer-term poor health outcomes?

Answer 6

• Respiratory distress syndrome (not enough surfactant)
• Increased risk of chronic lung disease
• Increased risk of cerebral palsy, cognitive impairment, and behavioural problems
• CKD risk increased (makes sense, also linked to low birth weight)
• Increased risk of insulin resistance and T2DM (!!!)