High risk newborn 1

High risk newborn 1

1. HIGH RISK NEWBORN Ms ULFAT AMIN M.Sc. CHN, DNA, RN

2. INTRODUCTION At birth ,  the newborn assumes the functions of breathing, eating, digesting, eliminating, and stabilizing his /her own body temperature. If problems related to any of these vital functions develop, the newborn is likely to have difficulty surviving. The newborn with such a complication is considered a compromised or high-risk newborn.

3. DEFINITION The high-risk neonate is defined as a newborn, regardless of gestational age or birth weight, who has a greater-than- average chance of morbidity or mortality. The high-risk period begins at the time of viability up to 28 days after birth and includes threats to life and health that occur during the prenatal, Perinatal and postnatal periods.

4. CLASSIFICATION According to Size According to Gestational Age According to Mortality

5. Low-birth-weight (lbw) — A newborn baby whose birth weight is less than 2500 g , regardless of gestational age. Very low–birth-weight (vlbw) — A newborn baby whose birth weight is less than 1500 g Extremely low–birth-weight (elbw) — A newborn baby whose birth weight is less than 1000 g Classification According to Size

6. Small-for-date (SFD) or small-for-gestational-age (SGA) infant— A baby whose rate of intrauterine growth was slowed and whose birth weight falls below the 10th percentile on intrauterine growth curves. SFD are of three types: Malnourished small for date babies Hypoplastic small for date babies Mixed

7. Intrauterine growth restriction (IUGR)— Found in babies whose intrauterine growth is retarded (sometimes used as a more descriptive term for the SGA infant) Large-for-gestational-age ( lGA ) —A neonate whose birth weight falls above the 90th percentile on intrauterine growth charts

8. Preterm (premature) — A neonate born before completion of 37 weeks of gestation, regardless of birth weight Full-term A neonate born between the beginning of 38 weeks and the completion of 42 weeks of gestation, regardless of birth weight Post term (post mature) — A newborn born after 42 weeks of gestational age, regardless of birth weight. 2. According to Gestational Age

9. 3. According to Mortality

10. LOW BIRTH WEIGHT BABIES A neonate with the birth weight of less than 2500g irrespective of gestational age are termed as low birth weight babies. They include both pre-term and small-for-date babies. The prevalence of LBW in India has been reported to range from 21% to 33%. These babies have nearly 40 % higher risk of mortality, morbidity childhood growth failure and developmental problems as compared to normal weight neonates .

11. Causes of low birth weight babies Previous pregnancy resulted in a low birth weight baby. Uterine abnormalities. Cervix abnormalities Maternal high blood pressure. Maternal diabetes . Smoking Fetal infection

12. Clinical features of low birth weight babies

13. Appearance

14. Lanugo hair

15. Ear cartilage

16. Breast nodule

17. In males, the scrotum does not have rugae and testes are not descended into the scrotum. In female infants, the labia are widely separated, not covering the labia minora, resulting in the prominent appearance of the clitoris. Skin : The skin of preterm neonate is thin, transparent and gelatinous, whereas that of a term neonate is thick and keratinized.

18. Sole creases

19. External genitalia

20. External genitalia

21. Complications Low oxygen level at birth. Inability to maintain body temperature. Difficulty feeding and gaining weight. More chances of infection. Breathing problems such as intraventricular hemorrhage.

22. Gastrointestinal problems such as necrotizing enterocolitis . Sudden infant death syndrome. Meconium aspiration syndrome. Polycythemia Hyperbilirubinemia Patent ductus arteriosus

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