1.

Premature

Before birth, the placenta serves three major roles for the fetus: provision of all the for growth,
elimination of fetal waste products, and synthesis of hormones that promote fetal growth.
With the exception of most electrolytes, the maternal circulation contains more substrate (eg,
blood glucose) than the fetal circulation. In addition, the placenta is metabolically active and
consumes glucose. Waste products of fetal metabolism (eg, heat, urea, bilirubin, carbon dioxide)
are transferred across the placenta and eliminated by the mother's excretory organs (ie, liver,
lung, kidneys, skin).
In addition, the placenta acts as a barrier to infection through mucosal macrophages and by
allowing transfer of maternal immunoglobulins (immunoglobulins such as immunoglobulin G
[IgG]) to the fetus beginning at 32-34 weeks' gestation. Placental dysfunction is involved in the
transfer of IgG. Antibacterial activity of the amniotic fluid improves as gestational age advances.

Each of the immature organs of a premature infant has functional limitations. The tasks of
caregivers in neonatal intensive care units (NICUs) are to recognize and monitor the needs of
each infant and to provide appropriate support until functional maturity can be achieved.

2. Post mature

In most cases, fetal growth continues until delivery. However, in some cases, the placenta involutes as
pregnancy progresses multiple infarcts and villous degeneration develop, causing placental
insufficiency. In these cases, the fetus receives inadequate nutrients and oxygen from the mother,
resulting in a thin (due to soft-tissue wasting), undernourished infant with depleted glycogen stores and
decreased amniotic fluid volume. Such infants are dysmature and, depending on when placental
insufficiency develops and the severity of the condition, they may be small-for-gestational-age. Although
placental insufficiency with dysmaturity can occur at any gestational age, it is most common in
pregnancies that progress beyond 41 to 42 weeks.

3. Sga

In SGA, the nutrient supply to the fetus is compromised. The fetus, in order to increase its
chance of survival, responds by reducing its overall size, preserving brain growth, accelerating
lung maturation, and increasing red blood cell production. The fetus redirects blood flow from
less vital organs to the brain, heart, adrenal glands, and placenta. Total body fat, lean mass, and
bone mineral content are reduced, resulting in a wasted appearance in infants with severe SGA.
Nitrogen and protein content are lower because of reduced muscle mass. Glycogen content is
decreased in skeletal muscle and liver because of lower fetal plasma glucose and insulin
concentrations.
4. Lga
Infants who are large for gestational age have been subjected to an overproduction of growth
hormone in utero. This most frequently happens with infants of diabetic mothers who are
poorly controlled. It may also occur in multiparous pregnancies because with each pregnancy
babies tend to grow larger.
Other associated conditions include transposition of the great vessels, Beckwith syndrome and
congenital anomalies