Pre-term Infant Flashcards
Over __% of deaths in childhood occur in the 1st year of life, and are strongly influenced by ________ delivery and low birth _____. With risk factors including _________ ___, _______ and ________ circumstances,
Over 50% of deaths in childhood occur in the 1st year of life, and are strongly influenced by pre-term delivery and low birth weight. With risk factors including maternal age, smoking and disadvantaged circumstances,
Which babies are more at risk of death?
Black or black british
Asian or asian british
Teenage mothers
Mothers over 40
Mothers living in poverty
__ _______ babies are born preterm every year
15 million
Why is the number of preterm babies increasing?
- Increased maternal age
- Increasing rate of pregnancy-related complications
- greater use of infertility treatments
- more cesearean deliveries before term
What are the causes of preterm birth?
- spontaenous preterm labour
- preterm rupture of membranes
- multiple pregnancy
- pregnancy associated hypertension
- cervical incompetence/uterine malformation
- antepartum haemorrhage
- IUGR
What are the risk factors for preterm birth
- > 2 preterm deliveries increases the risk of another premature baby by 70%
- abnormally shaped uterus increases the risk of giving birth by 19%
- women are 9 times more likely to give birth early if they have a multiple pregnancy
- interval of <6 months between pregnancies
- concieving through IVF
- smoking, drinking alcohol and using ilicit drugs
- poor nutrition, chronic conditions (hypertension, diabetes), multiple miscarriages or abortions
What is the difference in managing a preterm baby?
- need more help to stay warm
- have more fragile lungs
- don’t breathe effectively
- have fewer reserves
- delay cord clamping if possible
How are preterm babies best kept warm?
Place them while still wet in a suitable plastic bag and later under a radiant heater
What are the common problems of prematurity?
- temperature control
- feeding/nutrition
- sepsis
- system immaturity/dysfunction
- RDS
- PDA
- IVH
- NEC
- others; metabolic, ROP (retinopathy of prematurity)
Why is thermal regulation ineffective in premature babies?
- Low BMR
- minimal muscular activity
- subcutaenous fat insulation is negligible
- high ratio of surface area to body mass
What are the methods of keeping babies warm?
- wrap or bags
- skin to skin care
- prewarmed incubator
- transwarmer mattress
Why is there an increased risk of nutritional compromise in premature babies?
- limited nutrient reserves
- gut immaturity
- immature metabolic pathways
- increased nutrient demands
What causes early onset neonatal sepsis?
Mainly due to bacteria acquired before and during delivery
What causes late onset neonatal sepsis?
Acquired after delivery (nosocomial or community sources)
What organisms cause early onset neonatal sepsis?
Group B streptococcus
Gram negatives
