Premature Birth Flashcards
Premature Birth
Child born before the 37th week of prenacy
- Have complicated medical problems
- Earlier a child is born the more likely they are to develop complications
Late Preterm Births
Babies born between 34 and 36 weeks of gestation
Very Preterm Births
Babies born during less than 32 weeks of gestation
Extremely Preterm Births
Babies born at or before 25 weeks
Needs of Premature babies
- Need to stay in the hospital longer and possibly in special care unity (NICU))
- Preterm children may immediately need help with feeding and adapting to life outside of their mother
Prematurity can result in many…
Short-term and long-term complications that can be addressed by an OT in the hospital setting or after discharge in an outpatient or home setting
Symptoms of Prematurity
- Small size
- Sharp-looking features
- Lanugo covering musch of the body
- Low body temp
- Labored breathing
- Lack of suck-swallow reflex
Risk Factors for Premature Birth
- Previous preterm birth
- Being pregnant with multiples
- Short duration between pregnancies
- Tobacco and drig use
- Infections in the mother
- Mother having chronic conditions such as diabetes, high BP, and stressful life events
Short-term complications of prematurity
- Breathing problems
- Heart problems
- Brain problems
- Temperature control problems
- Gastrointestinal problems
- Blood problems
- Metabolism problems
- Immune system problems
Long-term complications of prematurity
- Cerebral palsy
- Impaired learning
- Vision problems
- Hearing problems
- Dental problems
- Behavioral and psychological problems
- Chronic health issues
- Also at a higher risk of sudden infant death syndrome
What is the incidence rate of Prematurity?
- 13% of all pregnancies globally result in premature birth, accounting for:
- The majority of all neonatal deaths
- 50% of all neonatal neurodevelopmental conditions including cerebral palsy
What are the contributing factors to preterm birth?
- Maternal and Socioeconomic factors:
- Fetal Health Factors:
Maternal and Socioeconomic Factors (contributing factors to preterm birth)
- Fertility assistance such as in vitro fertilization and multiple gestation births from fertility drugs
- Maternal age above 36 years, or below 18 years of age, maternal infections, poor prenatal care, history of previous preterm births, preeclampsia, smoking and other substance use, poverty
Fetal Health Factors (contributing factors to preterm birth)
Congenital anomalies or in utero injuries to the developing fetus, Rh incompatibility
Prevention of Preterm Low Birth Weights
- Early identification of women at risk – offering education and prenatal health care
- Early detection of pre-term labor and use of antenatal steroid therapy
Low-birth weight (LBW)
Birth weight less than 2,500 grams (5 ½ lbs)
Very low-birth weight (VLBW)
Birth weight less than 1,500 grams (3 ½ lbs)
Extremely low-birth weight (ELBW)
birth weight less than 800 grams (1 ¾ lbs)
-Also referred to as a micropreemie
Why is Gestational Age important?
- Neonates who have a birth weight below the 10th percentile based on a graph of population-specific birth weight when compared to gestational age. Infants can be either full term or premature to classify as small for gestational age, or SGA.
- Determining gestational age can determine an appropriate-for-gestational-age from a SGA age infant.
- SGA infants are typically small due to intrauterine growth restriction (IUGR). Half of SGA births are associated with maternal illness, smoking, or malnutrition
- Increased risk for long-term growth impairments and developmental disabilities
- After birth, gestational age can be assessed using a clinical scoring system called the modified Dubowitz exam.
Physical Characteristics of the Preterm Infant
- Thin, smooth reddish skin, presence of fine body hair, known as lanugo. Absence of skin creases, body fat, or ear cartilage.
- Decreased muscle tone and motor activity
- Increased joint mobility
Consequences and Complications of Prematurity-Respiratory System
- Respiratory Distress Syndrome (RDS)
- Bronchopulmonary Dysplasia (BDP)
Respiratory Distress Syndrome (RDS)
Characterized by respiratory distress in the newborn period.
- Decreased production of surfactant to keep the alveoli open
- One of the most common and most life-threatening problems for preterm infants; diagnosis is specific to a) immaturity of the lungs, and b) lack of surfactant production in the premature infant
Medical Management of RDS:
- Neonate given injection of surfactant replacement; most cases resolve within 96 hours.
- Low level of oxygen or continuous positive airway pressure (CPAP)
- Possible mechanical ventilatory support for severe cases
Bronchopulmonary Dysplasia (BDP)
- This term used to describe infants who require supplemental oxygen or mechanical ventilation beyond 28 days postnatal age and/or a corrected age of 36 weeks.
- BPD will begin as a respiratory distress syndrome that has not resolved.
- Most common chronic lung disease of children in the U.S.
- Occurs primarily in infants born less than 32 weeks gestation and require mechanical ventilation in the first week of life
- Severe BPD more commonly associated with neonatal sepsis and lung injury
- Increased risk for neurodevelopmental disorders, cerebral palsy and seizures