Prematurity and High-Risk Infants
Introduction[edit | edit source]
Prematurity is a significant healthcare problem occurring on over 10% of live birth every year.[1] The World Health estimates there are 15 million preterm births every year. [2] They categorize preterm birth into the following three categories:
- extremely preterm (< 28 weeks)
- Very preterm (28–32 weeks)
- Moderate to late preterm (32–36 weeks)[3]
Preterm infants have an increased risk for neurodevelopmental disorders and delayed growth with some developing neurological sequelae such as cerebral palsy, decreased intelligence and delayed neurodevelopment.[4]Neurodevelopment and growth in preterm infants can be affected by:
- gestational age
- birth weight
- length of hospitisation
- Apgar score
- cardiopulmonary resuscitation (CPR)
- ventilation
- breastfeeding[4]
[1,2]. I[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].[1]
Advances in perinatal and neonatal care have led to improved survival in preterm infants [1,2,3]. T 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 [[4]
[1,2]. I[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].[1]
However, infants born at earlier gestational age are at increased risk for recurrent hospitalizations, complex medical conditions, and neurodevelopmental impairments [6][5]
Complications[edit | edit source]
Morbidity and mortality rates increase with shorter gestational age, with girls tending to fare better than boys
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[3]
References[edit | edit source]
- ↑ 1.0 1.1 1.2 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.
- ↑ 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.
- ↑ 3.0 3.1 Pravia CI, Benny M. Long-term consequences of prematurity. Cleveland Clinic journal of medicine. 2020 Nov 23;87(12):759-67.
- ↑ 4.0 4.1 4.2 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.
- ↑ 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.
