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Neonate > Complications of prematurity > Flashcards

Complications of prematurity Flashcards

1
Q

How are preterm infants defined?

A

Infants born before 37 completed weeks of gestation are referred to as preterm.

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2
Q

How does the rate of morbidity and mortality in preterm infants compare to term infants?

A

Preterm infants have a higher rate of morbidity and mortality than term infants.

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3
Q

How does the level of prematurity affect preterm infants?

A

The more immature the infant, the more complications they may experience and the higher the risk of mortality.

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4
Q

Division of complications of prematurity

A
  • Immediate (At birth and within 24 hours of life).
  • Early (1st 7 days of life).
  • Late (1st month of life).
  • Long term (Beyond 1st month of life).
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5
Q

Immediate complications

A
  1. Hypothermia
  2. Hypoglycemia/ Feeding problems
  3. Respiratory distress
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6
Q

Early Complications

A
  1. Infections/ Sepsis
  2. Jaundice
  3. Apnea of prematurity
  4. Patent ductus arteriosus
  5. Intraventicular heamorrhage (IVH)/ Germinal Matrix Hemorrhage
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7
Q

Late complications

A
  1. Necrotizing enterocolitis (NEC)
  2. Anemia of prematurity
  3. Metabolic Bone Disease (MBD)
  4. Retinopathy of prematurity (ROP)
  5. Periventricular leukomalacia (PVL)
  6. Chronic lung disease (CLD)/ Bronchopulmonary dysplasia (BPD)
  7. Iron deficiency anemia
  8. Increased risk of respiratory illness and SIDS (sudden death syndrome)
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8
Q

Long term complications

A

1.Cerebral palsy, blindness, deafness
2. Cognitive and behavoural deficits
3. In growth restricted infants there is a higher chance of short
stature and metabolic syndrome (Barker hypothesis)

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9
Q

What is the target normal axillary temperature for preterm infants?

A

The target normal axillary temperature for preterm infants is 36.5 – 37.5 °C.

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10
Q

Define hypothermia in preterm infants.

A

Hypothermia in preterm infants refers to a temperature below 36.5 °C.

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11
Q

Why are preterm infants prone to hypothermia?

A

Preterm infants are prone to hypothermia due to factors such as thin skin, little subcutaneous fat tissue, large surface area to body weight ratio, and immature thermoregulatory centers in the brain.

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12
Q

Various causes of respiratory distress

A

-Hyaline membrane disease
- Wet lung syndrome

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13
Q

What is the timeframe for early-onset sepsis in neonates?

A

Early-onset sepsis occurs within the first 72 hours of life.

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14
Q

Why are preterm infants at particular risk for sepsis?

A

Preterm infants are at particular risk due to their immature immune system and diminished antibody transfer from their mothers.

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15
Q

When does physiological jaundice typically present in neonates?

A

Physiological jaundice typically presents between days 2 and 5 after birth.

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16
Q

What factors contribute to physiological jaundice in neonates?

A
  • Shortened life span of the red blood cell (RBC).
  • Increased hemolysis after birth.
  • Immaturity of the liver and low level of hepatic enzymes responsible for the
    conjugation and excretion of bilirubin
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17
Q

Define apnea of prematurity.

A

Apnea of prematurity is the cessation of breathing for 20 seconds or less, often associated with bradycardia and/or cyanosis.

18
Q

Who is more commonly affected by apnea of prematurity?

A

Apnea of prematurity is more common in preterm infants due to the immaturity of the respiratory center.

19
Q

What is the current drug of choice for the treatment of apnea in preterm infants?

A

Caffeine citrate is currently the drug of choice for the treatment of apnea in preterm infants.

20
Q

Why is caffeine citrate preferred over other methylxanthines?

A

Caffeine citrate is preferred because it can be given orally as a once-a-day dose and has a wide therapeutic window.

21
Q

What is intraventricular hemorrhage (IVH)?

A

Intraventricular hemorrhage is bleeding into the ventricles of the brain, commonly seen in premature infants.

22
Q

What complication may result from IVH?

A

IVH may lead to post-hemorrhagic hydrocephalus, a condition characterized by the accumulation of cerebrospinal fluid in the brain.

23
Q

When does necrotizing enterocolitis (NEC) generally occur in premature infants?

A

Generally, the lower the gestational age, the later NEC occurs.

24
Q

When do signs of anemia typically appear in preterm infants?

A

The preterm infant tends to show signs of anemia by 4-8 weeks old.

25
Q

What is metabolic bone disease (MBD) in premature infants?

A

Metabolic bone disease (MBD) is a condition characterized by poor bone mineralization, commonly seen in preterm infants due to calcium and phosphate deficiency.

26
Q

When does MBD typically occur in preterm infants?

A

MBD usually manifests between 3 to 12 weeks of life in preterm infants.

27
Q

Which biomarkers are commonly used to assess bone mineralization in MBD?

A

Alkaline phosphatase (ALP) and phosphorus are the two most commonly used biomarkers for assessing bone mineralization in MBD.

28
Q

How is metabolic bone disease managed in preterm infants?

A

Management involves fortifying breast milk and providing phosphate supplements to address phosphate deficiency.

29
Q

What is retinopathy of prematurity (ROP)?

A

Retinopathy of prematurity (ROP) is a leading cause of blindness in children worldwide, characterized by abnormal development of retinal blood vessels in preterm infants.

30
Q

What are the risk factors for developing ROP?

A
  • GA < 32weeks or birth weight < 1250g.
  • Infections.
  • Supplemental oxygen.
  • Hypoxia.
  • Anemia.
31
Q

When is ROP typically observed in preterm infants?

A

ROP is typically observed at 31–34 postmenstrual age in preterm infants.

32
Q

How is ROP managed?

A

Management options include laser therapy or monoclonal antibodies injected into the eyes. Approximately 90% of cases resolve without damage to the retina, but severe cases may lead to retinal detachment and blindness.

33
Q

What is periventricular leukomalacia (PVL)?

A

Periventricular leukomalacia (PVL) is brain injury resulting from damage to the white matter around the brain’s ventricles. It commonly leads to spastic diplegia.

34
Q

How is PVL diagnosed?

A

PVL is diagnosed using ultrasound or magnetic resonance imaging (MRI) techniques

35
Q

What are the common complications of PVL?

A

Spastic diplegia is the most common complication associated with PVL.

36
Q

What is chronic lung disease (CLD) or bronchopulmonary dysplasia (BPD)?

A

LD/BPD is a chronic lung condition in preterm infants, marked by oxygen therapy need for ≥28 days and continued dependence at 36 weeks postmenstrual age.

37
Q

What are the defining features of CLD/BPD?

A

Prolonged oxygen requirement for ≥28 days and dependence at 36 weeks postmenstrual age.

38
Q

What are the defining features of CLD/BPD?

A

Prolonged oxygen requirement for ≥28 days and dependence at 36 weeks postmenstrual age.

39
Q

What causes CLD/BPD?

A

Interrupted alveolarization in preterm infants and subsequent neonatal lung damage.

40
Q

What is iron deficiency anemia?

A

Iron deficiency anemia is a condition where there’s insufficient iron in the body to produce hemoglobin, leading to decreased oxygen-carrying capacity of the blood.

41
Q

When does iron deficiency anemia typically occur, and what are its causes?

A

It usually occurs around 4-6 months due to low iron stores from birth. Causes include inadequate iron intake, premature birth, and rapid growth.

42
Q

How can iron deficiency anemia be prevented?

A

It can be prevented by delayed cord clamping at birth and iron supplementation starting from one month of age.

Neonate (34 decks)

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