FIRST READ PREPLADDER AND FOR CONCEPT READ ENDEAVOUR AND THEN GO THROUGH NOTE (ENOUTH FOR EXAM)

IMPORTANT FOR EXAM ARE HIGHLIGHTED WITH RED AND GOLDEN

PRETERM INFANT
1. Q: Definition of infant?

Ans: An infant born before 37 weeks completed gestational age following onset of the last menstrual period is arbitrarily defined as preterm
infant.

Infants born before 37 completed weeks usually weighting <2500 gms.

2. Q: What are the classification of preterm infant? (REVIEW)

Ans: It classified according to birth weight and gestational age.

Birth weight Gestational age

LBW(Low birth weight) < 2500g Moderately preterm(33-36 weeks)
VLBW(Very Low Birth Weight) < 1500g Very preterm (＜32 weeks)
ELBW(Extremely Low birth Weight) < 1000g Extremely preterm(＜28 weeks)

3. Q: What are the causes or etiology?

Ans:

 Low socioeconomic status (SES)

 Women younger than 16 or older than 35
 Acute or chronic maternal illness
 Multiple-gestation births
 Obstetric factors
Premature rupture of membranes
Amnionitis
Placenta previa
Abruptio placentae
Uterine malformations
Uterine trauma
Hypertensive disorders
Preterm cervical shortening
Previous cervical surgery
 Fetal conditions

4. Q: Global incidence?

Ans:

Region Preterm births Preterm birth rate 95%Confidence intervals

(×1000) (%)

World Total 12,870 9.6 9.1-10.1

More developed regions 1,014 7.5 7.3-7.8

Less developed regions 7,685 8.8 8.1-9.4

Least developed regions 4,171 12.5 11.7-13.3

Africa 4,4047 11.9 11.1-12.6

Asia 6,907 9.1 8.3-9.8

 Europe 466 6.2 5.8-6.7

Latin America﹠the Caribbean 933 8.1 7.5-8.8

North America 480 10.6 10.5-10.6

Oceania(Australia/New Zealand) 20 6.4 6.3-6.6

5. Q: What are the medical problems?

Ans:

 Need for resuscitation and stabilization at birth

 Respiratory
o Respiratory distress syndrome(RDS)
o Pneumothorax
o Apnea and bradycardia and desaturations
 Hypotension
 Patent ductus arteriosus
 Temperature control
 Metabolic
o Hypoglycaemia
o Hypocalcaemia
o Electrolyte imbalance
o Osteopenia of prematurity
 Nutrition

6. Q: How to differentiate or compare preterm infant from / with term infant?

Ans:

7. Q: Mortality of preterm infant?

Ans:

8. Q: Morbidity of preterm infant?

Ans:

9. Q: Baby weighting 610gm at 26 weeks completed gestational age and another baby weighing 500gm at 23 weeks of gestational age. Both of
them save or not?

Ans:

Two threshold levels

1) Lower threshold of no resuscitation (<22 weeks)

2) Upper threshold of obligatory resuscitation (＞25 weeks)

The 22 to 24 week range becomes the gray zone (Here there should not be do the resuscitation, because the infant doesn’t develop that much)

So, in this image, 26th week of infant is safe enough to do resuscitation to save the infant’s life.

23th week of infant is less viable and there is less possibility of survival as it falls under gray zone which indicates no resuscitation.
10. Q: How to stabilize preterm or sick infant?

Ans: