Low birth weight and prematurity

1. Prematurity
By Okumu Atanas

2. Key terms
• Infants whose weight is appropriate for their gestational ages are
termed appropriate for gestational age (AGA).
• Infants who are heavier than expected are termed as large for
gestational age (LGA);
• Those smaller than expected are considered small for gestational age
(SGA), and are they also usually found to be intrauterine growth
restricted (IUGR) prior to birth.

3. Prematurity
• Prematurity is a term for the broad category of neonates born at less
than 37 weeks' gestation. Preterm birth is the leading cause of
neonatal mortality and the most common reason for antenatal
hospitalization.
• For (extremely low birth weight-ELBW) premature infants born with a
weight below 1000 g, the three primary causes of mortality are
respiratory failure, infection, and congenital malformation.

4. • Infants born with a birth weight less than 1500 g are defined as very
low birth weight (VLBW) infants.
• Low birth weight is less than 2500 g

5. Signs and symptoms
Ballard Scoring
System
(i) Ear cartilage (eg, a
preterm infant at 28
weeks’ gestation has
a small amount of ear
cartil isage and/or a
flattened pinna)

6. (ii) Sole (eg, a preterm
infant at 33 weeks’
gestation has only an
anterior crease on the
sole of the foot)

7. (iii) Breast tissue
(eg, a preterm
infant at 28 weeks’
gestation has no
breast tissue, and
the areolae are
barely visible

8. Laboratory studies
• Frequent blood glucose-hypoglycemia and hyperglycemia
• Complete blood count (CBC)-Anemia or polycythemia
• White blood cell (WBC) –infection
• Blood type and antibody testing (Coombs test)
• Serum electrolyte levels

9. Management
• prompt respiratory
• thermal management 36.5º to 37.5ºC
• Fluid and electrolyte management: water, glucose, calcium, TPN
• Monitor urine output, serum electrolyte levels, and daily weight
• exogenous surfactant agents, maternal steroids