Preterm Infant

Question 1

What is the definition of a Preterm baby?

Answer 1

Born before 37 weeks

Question 2

What is extreme preterm?

Answer 2

<27 weeks

Question 3

What is very preterm?

Answer 3

<32 weeks

Question 4

What is a term birth

Answer 4

Between 37-42 weeks

Question 5

Fetal loss is before what week?

Answer 5

Before 22 weeks

Question 6

What caused a decrease in premature births?

Answer 6

Smoking ban

Question 7

7 Risk Factors associated with neonatal deaths?

Answer 7

1. Pre term delivery
2. Low birth weight
3. Twins or multiple births
4. Maternal age
5. Ethnic minorities
6. Smoking
7. Disadvantaged circumstances

Question 8

How many babies die in the UK every day (after 24 weeks of life)?

Answer 8

15 babies

Question 9

How many babies are born preterm globally every year?

Answer 9

15 million

Question 10

4 Reasons for increasing number of preterm births?

Answer 10

1. Increasing maternal age
2. Increasing rate of pregnancy complications
3. Greater use of infertility treatments
4. More caesarean deliveries before term

Question 11

7 Causes of Preterm births?

Answer 11

1. Spontaneous preterm labour
2. Multiple pregnancy
3. Preterm pre-labour rupture of membranes
4. Pregnancy associated hypertension
5. Intrauterine growth restriction
6. Antepartum haemorrhage
7. Cervical incompetence/uterine malformation

Question 12

6 Risk factors for Having a Preterm Births?

Answer 12

1. > 2 deliveries preterm increases the risk of another premature baby by 70%
2. Abnormally shaped uterus
3. 9 times more likely to give early if there is a multiple pregnancy
4. Spacing between pregnancies <6 months
5. Conceiving through in vitro fertilisation
6. Smoking, drinking alcohol, illicit drug use

Question 13

List 2 common problems of prematurity

Answer 13

1. Temperature

2. Nutrition/feeding

Question 14

Why do premature babies need help staying warm?

Answer 14

They have a low BMR, minimal muscular activity, high surface area to body mass ratio and do not have subcutaneous fat to insulate them.

Question 15

Why do premature babies need help with nutrition?

Answer 15

• limited nutrient reserves
• gut immaturity
• immature metabolic pathways
• increased nutrient demands
• may not be able to suck

Question 16

Main causes of early onset sepsis?

Answer 16

• Group B streptococcus
• Gram negatives
  Acquired before or during delivery

Question 17

Main causes of late onset sepsis

Answer 17

• Coagulasse negative staphylococci
• Gram negatives
• Staph aureus

Question 18

Risk factors associated with sepsis in premature babies?

Answer 18

• Immature immune system
• intensive care environment
• Lines and tubes

Question 19

Respiratory complications associated with prematurity?

Answer 19

• Respiratory distress syndrome
• Apnoea of prematurity
• Bronchopulmonary dysplasia

Question 20

What is primary and secondary Respiratory distress syndrome?

Answer 20

Primary = surfactant deficiency and structural immaturity 
Secondary = intubation and ventilation causes damage to respiratory.

Question 21

Cardiac complications associated with prematurity?

Answer 21

Patent ductus arteriosus

Question 22

Neurological complications associated with prematurity?

Answer 22

Intraventricular haemorrhage

Question 23

What is an intraventricular haemorrhage?

Answer 23

Bleeding inside or around the ventricles, the spaces in the brain containing cerebral spinal fluid.

Question 24

GI complications associated with prematurity

Answer 24

Necrotising enterocolitis

Question 25

How does Necrotising enterocolitis occur?

Answer 25

Tissues in the intestine become inflamed and begin to die. This can lead to perforation and contents of the intestine leak into the abdomen. Premature babies have immature and fragile bowels which are not primed for motility yet.

Question 26

Other complications of prematurity?

Answer 26

• Retinopathy of prematurity

- Metabolic = hypoglycaemia, hyponatremia, osteomalacia of prematurity