Prematurity and High-Risk Infants
Introduction[edit | edit source]
The World Health Organization (WHO) estimates that there are 15 million preterm births every year [1][
Advances in perinatal and neonatal care have led to improved survival in preterm infants [1,2,3]. The survival rate is approximately 50% in infants aged 24 weeks, but it is 80% to 90% in infants aged 28 weeks and 95% in those aged 32 weeks in the United States [4]. However, preterm birth also increases the risk of chronic diseases and developmental delays that may persist into adulthood and, consequently, require higher levels of health care [5]. Overall, encouraging the growth and development of surviving premature infants is crucial, along with efforts to increase survival rates.
Premature infants are a high-risk group for delayed growth and neurodevelopmental disorders, and some have neurological sequelae, such as delayed neurodevelopment, decreased intelligence, and cerebral palsy [6,7]. Factors affecting the growth and neurodevelopment of premature infants include birth weight, gestational age, Apgar score, cardiopulmonary resuscitation (CPR) at birth, breastfeeding, ventilation, or length of hospitalization, among others [[2]
Occurring in over 10% of live births in the world annually, prematurity is considered a significant global healthcare problem [1,2]. In the USA, preterm births account for about 400,000 births per year, and their outcomes will define the health of a significant proportion of the next generation [1]. Preterm infants face several challenges during their neonatal intensive care unit (NICU) stay, including cardiorespiratory problems, infections, and neurological challenges, while continuing to grow and attain neurodevelopmental milestones for NICU discharge [3]. The respiratory morbidities and neurodevelopmental delays related to prematurity pose a heavy burden on the patients, families, and the healthcare system [4].[3]
However, infants born at earlier gestational age are at increased risk for recurrent hospitalizations, complex medical conditions, and neurodevelopmental impairments [6][4]
Complications[edit | edit source]
Due to a shortened period of in utero organ development, premature infants are at higher risk of chronic respiratory, cardiac, renal, and endocrine system disorders later in life.
s the third trimester of pregnancy (> 28 weeks) is a period of rapid organ growth and maturation, premature infants are born before major organ development is complete. Survivors of premature birth may have later adverse health effects related to organs failing to achieve optimal development or undergoing more rapid decline.10
References[edit | edit source]
- ↑ Pusdekar YV, Patel AB, Kurhe KG, Bhargav SR, Thorsten V, Garces A, Goldenberg RL, Goudar SS, Saleem S, Esamai F, Chomba E. Rates and risk factors for preterm birth and low birthweight in the global network sites in six low-and low middle-income countries. Reproductive Health. 2020 Dec;17(3):1-6.
- ↑ Kang SR, Cho H. Research trends of follow-up care after neonatal intensive care unit graduation for children born preterm: a scoping review. International journal of environmental research and public health. 2021 Mar 22;18(6):3268.
- ↑ Kamity R, Kapavarapu PK, Chandel A. Feeding Problems and Long-Term Outcomes in Preterm Infants—A Systematic Approach to Evaluation and Management. Children. 2021 Dec 8;8(12):1158.
- ↑ Grunberg VA, Geller PA, Bonacquisti A, Patterson CA. NICU infant health severity and family outcomes: a systematic review of assessments and findings in psychosocial research. Journal of Perinatology. 2019 Feb;39(2):156-72.
