LOW BIRTH WEIGHT BABY

1. MR.SACHIN GADADE
M.SC(N) PEDIATRICS
LOW BIRTHLOW BIRTH
WEIGHT BABIESWEIGHT BABIES

2. DEFINITION:-
1.Preterm baby:-
a)A baby born before 37
completed weeks of gestation
calculating from the first day of
LMP is defined as “preterm
baby.”
- D.C Dutta
b) A fetus delivered between 20
& 37 weeks of gestation is
“preterm baby.”

3. DEFINITION:-
2. Low birth weight (LBW):-
“Defined as one whose birth weight is
less than 2500 grams. Irrespective of
gestational age.”
3. Small for gestational age (SGA):-
“The term is to designate the
newborns with birth weight les
than 10th
percentile or less then
two standard deviation for their
gestational age.”

4. INCIDENCE:-
Preterm baby constitutes 2/3
of low birth weight babies.
ETIOLOGY:-
Same as preterm labour.

5. MANIFESTATION:-
1. Anatomical:-
a) The weight is 2500 gms or less & length is
usually less than 44 cm.
b) Head & abdomen are relatively large,
skull bones are soft with wide sutures &
post fontanels.
c) Head circumference is disproportionately
exceeds that of chest.
d) Pinnae of ear are soft & flat.
e) Eyes are kept closed.
f) Skin is red shiny D/T lack of subcutaneous
fat & covered by plentiful lanugo & vernix
caseosa.

6. MANIFESTATION:-
g) Plantar creases are not visible.
h) Testicles are undescended , labia minora are exposed because
labia majora in contact.
i) Nails are not grown right upto the finger tips.

7. FUNCTONALLY:-
a) CNS:- Lethargic & inactivity, poor cough
reflex.
b) CVS:- About 1/3rd
of babies have PDA.
c) RS:- RDS, pulmonary aspiration &
atelactesis are common.
d) GI:- Difficulties in feeding D/T poor
sucking, small capacity of stomach.
Hepatic immaturity leads to
hyperbilirubinaemia which may be
aggravated by delayed feeding,
dehydration & hypoxia.

8. e) Thermoregulation :-
Temperature regulating centre is
immature, heat loss is excessive. Hence
preterm infant develop hypothermia.
f) US:- D/T renal immaturity preterm
infant develop elevation of BUL, BUN,
acidosis & dehydration.
g ) Infection:- low levels of IgG
antibodies preterm babies are prone t
infection.
12/26/17 8MR.SACHIN GADADE

9. MANAGEMENT :-
CARE OF PRETERM BABY AFTER
BIRTH :-
 Immediate management after
birth:-
1.Cord to be clamped quickly to
prevent hypervolemia & later on
development of
hyperbilirubinaemia.
2.Air passage should be cleared.
3.Adequate O2 therapy (O2
concentration 35% )

10. 4. Vit. K 1mg IM to prevent
hemorrhages.
5. Body should be handled
carefully. Bathing is not
appropriate for a
premature baby.

11. PRINCIPLES OF MANAGEMENT :-
1. To maintain body temperature -
2. Respiratory support -
3. Prevention of infection –
4. To maintain nutrition –
5. Adequate nursing care -

12. COMPLICATION :-
1. Asphyxia
2. Cerebral hemorrhage
3. Fetal shock
4. Heart failure
5. Edema
6. Infection
7. Jaundice
8. Anemia
9. Retrolental fibroplasia

13. PATHOLOGY:-
High conc. Of O2 for prolonged period
Induces vasoconstriction specially temporal
portion of retina
Anoxia damage to endothelium
Regeneration of new vessels in area occurs
after the O2 therapy is withdrawn
13

14. Extension of revascularization beyond the retina into
vitreous
Dilatation of vessels – rupture
Fibrosis
Adhesions – detach retina
Blindness

15. Definition:-
Babies with a birth weight of less
than 10th
percentile for their gestational
age. They are also termed as small for
gestational age (SGA)
12/26/17 15MR.SACHIN

16. Maternal :-
 short stature mother
 primi or grand multipara
 teenage pregnancy
 low Pre-Pregnant weight
 maternal illness- anemia, heart disease, malaria
 complications of pregnancy – PIH
 smoking, alcoholism or drug abuse by mother
 poor weight gain during pregnancy
 previous similar baby
Causes
12/26/17 16MR.SACHIN

17. Placental factors:-
 disorders of placental implantation
 Abruptio placenta
 single umbilical artery
 structural & functional abnormalities of placenta
umbilical cord.
Fetal Factors:-
first born babies are generally smaller
twin or multiple pregnancy
intrauterine infections
genetic or chromosomal aberrations
12/26/17 17MR.SACHIN

18. Environment factors :-
 poor socioeconomic status
 nutritional habits
 cultural practices
12/26/17 18MR.SACHIN

19. Types :-
the babies with SFD are found as three different
types.
1. Malnourished small for dates infants:
 These babies appear long, thin and alert
 They look marasmic poor subcutaneous fat & poor
muscle mass.
 They have excess skin folds on the buttocks & thigh.
 The difference in head circumference and chest
circumference is more then 3 cms.
 The internal organs such as liver thymus & lungs are
shrunken but pulmonary alveoli are mature as per the
gestation.
12/26/17 19MR.SACHIN

20. 12/26/17 SHASHIKANT 20
In these infants the growth arrest
probably occurred in the later part
of pregnancy due to reduction in
the cell size but not the cell number
Prognosis of physical growth is
better

21. 2. Hypo plastic SFD :-
In case of intrauterine infection, genetic
defects & chromosomal aberration growth
retardation occurs in the early part of the
pregnancy, the no of body cell is reduced these
babies are small including the head size, prognosis
is poor permanent mental& physical growth
retardation.
12/26/17 21MR.SACHIN

22. 12/26/17 SHASHIKANT 22
3. Mixed group:-
There is reduction in the cell no. & the cell size
because of the adverse factors operate during both
the early & mid pregnancy

23. Common problems of SFD Babies
 Birth asphyxia SFD infant suffer from prenatal asphyxia due to
maternal factors & placental insufficiency. Some of them pass me
conium in utero due to distress & are liable to develop me conium
aspirant syndrome.
 Fetal hypoxia & introspection death due to place dysfunction
 Inappropriate thermoregulation
12/26/17 23SHASHIKANT

24. 12/26/17 SHASHIKANT 24
Pulmonary hemorrhage polycythemia due to
unknown cause
Increased risk of infections
Poor growth potential
Metabolic changes these infants develop
hypoglycemia due to poor reserves of glycogen & fat.
Hypokalemia is frequent because of transient
hypoparathyroidism.

25. Management :-
Whenever a SFD fetus is suspected careful
observation of mother is made to determine LBW with
the help of USG. Majority of fetal deaths occur after
36th wk gestation so correct diagnosis is Essential.
Mother is advised for adequate bed rest in left lateral
position.
To correct malnutrition by balanced diet: 300 extra
calories per day to be taken
Avoid smoking & alcohol
Fetal growth & assessment of well being of for his to be
done, by NST.
12/26/17 25MR.SACHIN

26. THANK YOU----