Complications of prematurity

Jessica Peter Roscoe

Contents...
➢ Classifying prematurity
➢Case study
➢ Causes
➢Acute complications
➢ Chronic complications
➢Prevention
Classifying prematurity...
➢ Delivery prior to 36 weeks, 6 days
➢Incidence of 8-10%
➢ Varies with socio-economic
status
Considering a fictitious case...
➢ Daniel, 16 months
➢23 + 6
➢ Ten weeks in NICU
➢On permanent oxygen with
bronchopulmonary dysplasia
➢Developmental delay - adjusted age
Causes/predictors...
➢ Family history/previous
preterm (Daniel)
➢ Placental factors
➢ Cervical factors
➢ Social factors
➢ Maternal illness
➢ Fetal factors
➢ Idiopathic
➢ Iatrogenic
Acute complications
➢ Death (7.2% of live births are preterm, only 53% of
these children survive)
➢ Neurological problems
➢ Infections
➢ Respiratory problems
➢ Gastrointestinal problems
➢ Haematological problems
Chronic complications
➢ Cognitive - Learning disabilities
➢Respiratory - Bronchopulmonary
dysplasia
➢Movement - cerebral palsy
➢ Eyes - retinopathy of prematurity
➢Behavioural/psychological problems
Bronchopulmonary dysplasia
➢ Iatrogenic chronic lung disease
➢Ventilation & supplementary oxygen
➢ Arrested lung development
➢Mild, moderate, severe
➢ Some may need tracheostomy
➢Recurrent infections/hospital admissions
Daniels X-ray
➢ Hyperinflation
➢ Fibrosis
➢ Sometimes
atelectasis
➢ Typically symptoms
gradually resolve
(severity dependent)
How do we prevent prematurity?
Prevention...

➢Antibiotics for infections

➢ IVF limits
➢Cervical cerclage
Any Questions?