Preterm and small-for-dates babies

Question 1

Define pre-term - what is the threshold?

Answer 1

A neonate whose calculated gestational age from the LMP is <37 completed weeks

Question 2

Define LBW - what is the threshold?

Answer 2

Birth weight of <2.5kg regardless of gestational age

Question 3

Define very LBW (VLBW)

Answer 3

Birth weight of <1.5kg regardless of age

Question 4

Define extremely LBW (ELBW)

Answer 4

<1kg

Question 5

Define SGA

Answer 5

Birth weight below the 10th percentile for gestational age

Question 6

Define IUGR

Answer 6

Failure of growth in utero which may or may not result in the baby being SGA.

Question 7

Symmetrical SGA - what does this mean?

What is another name for it?

Answer 7

All growth parameters are symmetrically small suggesting the fetus was affected from early pregnancy

e.g. chromosomal abnormalities and constitutionally small babies

PROPORTIONAL

Question 8

Assymetrical SGA - what does this mean?

What is another name for it?

Answer 8

The weight centile is

Question 9

Chief Causes for preterm and small for date babies

Answer 9

Poverty 
poor social support 
constitutional factors 
malformation 
twins 
congenital infection 
placental insufficiency
maternal disease

Question 10

Are the effects of being small from birth permenant?

Answer 10

90% catch up in the first 2 years
They tend to be shorter than the mean adult height
Increased risk of coronary artery disease and obesity

Question 11

Causes of prematurity

Answer 11

Unknown 
Smoking tobacco
Poverty
Malnutrition 
PH of prematurity 
Genitourinary infection
Chorioamnionitis 
Pre-eclampsia 
DM

Question 12

When and how is gestational age checked?

Answer 12

Check EDD on 12 week scan

Question 13

Management

Answer 13

Delivery should take place in centre where they are specialised in preterm babies
Resuscitation when born
Take to NICU/SCBU
Plan supplemental breast milk/low birth weight formula if <2kg
Monitor BM