Infantools | General FeaturedImage

Definitions

Neonatal definitions are important in relation to categorization of infants into segments that carry a certain risk of associated morbidities. Newborns can be stratified based on Birth weight (BW), Gestational age (GA) and their relationship:

Gestational age

  • preterm newborns (< 37+0)
  • term newborn (37+0 to 41+6)
  • postterm newborn (> 41+6)

Birth weight

  • macrosomia (> 4500 g)
  • normal (2500 – 4500 g)
  • low birth weight [LBW] (< 2500 g)
  • very low birth weight [VLBW] (< 1500 g)
  • extremely low birth weight [ELBW] (< 1000 g)

Gestational age <> Birth weight

  • appropriate for GA [AGA] (eutrophic)
  • small for GA [SGA] (hypotrophic; BW is < 10.percentile for given GA)
  • large for GA [LGA] (hypertrophic; BW is > 90.percentile for given GA)

Mortality

Mortality rates

  • Perinatal mortality = stillbirths + live births that died during the first week of life (early neonatal mortality) for 1000 newborns
  • Neonatal mortality = newborns that died since birth up to 28 days of life for 1000 live births
  • Infant mortality = children that died since birth up 1 year of life for 1000 live births

Specific mortality = based on birth weight

Perinatal mortality = consequence of the most common perinatal complications:

  • infection / sepsis
  • congenital anomalies
  • perinatal asphyxia
  • hypoxic-ischemic encephalopathy (HIE)
  • peri/intraventricular hemorrhage (PIVH)

Morbidity

Morbidity = illness, deviation from the healthy status of a newborn

Early Morbidity

Late Morbidity

  • cerebral palsy (CP)
  • blindness
  • deafness
  • mental retardation (MR)
  • epilepsy
  • failure to thrive

References

ā‘  Brydges CR, Landes JK, Reid CL, Campbell C, French N, Anderson M. Cognitive outcomes in children and adolescents born very preterm: a meta-analysis.Ā Dev Med Child Neurol. 2018;60(5):452-468. doi:10.1111/dmcn.13685

Similar Posts

  • Late onset sepsis

    Late onset sepsis (LOS) is an infectious complication in newborns that have clinical presentation after the first 72 hours of life. Sometimes also called nosocomial due to pathogenesis – contact with mother, breastmilk, invasive procedures, hands of healthcare personnel. LOS episodes significantly contribute to neonatal mortality and morbidity rates and can have lifelong…

  • Persistent ductus arteriosus

    Persistent ductus arteriosus (PDA) connects aorta with main pulmonary artery (MPA) (or left pulmonary artery – LPA) and during fetal life serves as important right-left shunt => mixed blood flowing from the pulmonary artery to the descendant aorta and supplying the lower half of the body. PDA prenatally remains open due to low partial pressure…

  • Neonatal examination

    The goal of initial care after delivery is to ensure optimal conditions for postnatal adaptation and perform initial neonatal examination: bonding (mother – newborn) => important for lactation and neurodevelopment breastfeeding (suck reflex) prevent heat loss care for the umbilical cord temperature measurement birth weight (and length) Crede procedure (preventing gonococcal conjunctivitis) medical documentation and newborn ID…

  • Intraventricular hemorrhage

    The intraventricular hemorrhage in the preterm infants usually originates inĀ the germinal matrixĀ (temporary developmental structure with significant vascular supply due to massive mitotic and metabolic activity). The structure is divided from the cerebral ventricles only by a thin layer of subependymal cells and disappears after 34 weeks of gestation – one…

  • Apnea

    Apneas represent another important group of respiratory/ventilation dysfunctions in newborns (apart from perinatal asphyxia and respiratory distress syndrome). They are generally defined as a cessation of breathing movements and air flow for more than 20 seconds, thus often being accompanied by desaturation and bradycardia. Spontaneous breathing causes water in lungs to be resorbed into blood and…

  • Oxygen Therapy

    We should attempt to maintain normoxemic oxygenation in order to prevent hypoxic injury (mainly in the cerebral tissue). On the other hand, oxygen should be carefully titrated to newborns, especially preterm, due to the negative effects associated with its overuse (reactive oxygen species = ROS).  Hyperoxia induces the production of oxygen radicals that subsequently trigger…

Leave a Reply

Your email address will not be published. Required fields are marked *

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.