Maternal health and behaviors during pregnancy can significantly influence the health of the newborn. Some key risk factors discussed in the document include:
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2) Nutrition - Inadequate nutrition, anemia, obesity, and food contamination can restrict fetal growth and development.
3) Health behaviors - Smoking, substance abuse, and excessive medication/supplement intake increase risks of low birthweight, prematurity, and birth defects.
4) Medical conditions - Pregnancy complications like diabetes and hypertension as well as a history of infertility or loss can endanger
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In most cases, pregnancies follow a natural course and delivery of a baby is a smooth affair. However, complications may arise during pregnancy due to several causes, ranging from genetic makeup to preexisting medical conditions. Such pregnancies are known as high-risk pregnancies.
Introduction to Risk Factors for Pregnancy
Other Risk Factors For Pregnancy
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The primary aim of preconception and interconception care is to improve maternal health and birth outcome for mother, infant and family through prevention and interventions.
Every woman should be thinking about her health whether or not she is planning pregnancy. One reason is that about half of all pregnancies are not planned. Unplanned pregnancies are at greater risk of preterm birth and low birth weight babies. Another reason is that, despite important advances in medicine and prenatal care, about 1 in 8 babies is born too early. Researchers are trying to find out why and how to prevent preterm birth. But experts agree that women need to be healthier before becoming pregnant. By taking action on health issues and risks before pregnancy, you can prevent problems that might affect you or your baby later.
Discover the essential steps and expert advice for optimal pre-conception care. Learn how to enhance your fertility, ensure a healthy pregnancy, and lay the foundation for your baby's lifelong well-being
In any community, mothers and children constitute a priority group. In sheer numbers, they comprise approximately 71.14 per cent of the population of the developing countries. In India, women of the child bearing age(15-44 years) constitute 52.4 per cent of total female population, and children under 15 years of age about 26.5 per cent of the total population. Together they constitute nearly 57.5 per cent of the total population. By virtue of their numbers, mothers and children are the major consumers of health services, of whatever form.
Mothers and children not only constitute a large group, but they are also a "vulnerable" or special-risk group. The risk is connected with child-bearing in the case of women; and growth, development and survival in the case of infants and children. Whereas 50 per cent of all deaths in the developed world are occurring among people over 70, the same proportion of deaths are occurring among children during the first five years of life in the developing world. Global observations show that in developed regions maternal mortality ratio averages at 12 per 100,000 live births; in developing regions the figure is 232 for the same number of live births (1). From commonly accepted indices, it is evident that infant, child and maternal mortality rates are high in many developing countries. Further, much of the sickness and deaths among mothers and children is largely preventable. By improving the health of mothers and children, we contribute to the health of the general population. These considerations have led to the formulation of special health services for mothers and children all over the world.
The problems affecting the health of mother and child are multifactorial. Despite current efforts, the health of mother and child still constitutes one of the most serious health problems affecting the community, particularly in the developing countries. The present strategy is to provide mother and child health services as an integrated package of "essential health care", also known as primary health care which is based on the principles of equity, intersectoral coordination and community participation. The primary health care approach combines all elements in the local community necessary to make a positive impact on the health status of the population, including the health of mothers and children.
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(4) After birth, the child is
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VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
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to prevent antimicrobial overuse, misuse and abuse.
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1. MATERNAL HEALTH AND ITS
INFLUENCE ON CHILD HEALTH
Ms ARIFA T N
FIRST YEAR M.Sc NURSING, MIMS CON
2. INTRODUCTION
Most pregnancies are normal and result in a
healthy newborn.
Pregnant women can be unknowingly exposed
to potentially harmful physical, psychosocial,
Behavioral, or environmental conditions that
can increase pregnancy risk
There is growing evidence of the genetic
influence upon some perinatal risk factors and
of a link between exposure to environmental
triggers and perinatal outcomes
3. INTRODUCTION
Patient education, emotional support, and
assistance with lifestyle alterations necessary
for healthy pregnancy are key components of
prenatal care
Evaluation of maternal risk factors can help
anticipate many of the neonates who will be at
increased risk for problems at birth
4. MATERNAL RISK FACTORS
There is no way to accurately predict every
neonate who will be at risk since a cause-and-
effect relationship between high-risk maternal
characteristics or behaviors and poor
outcomes is not always clearly defined
One of the most essential ways to decrease
problems of prematurity, LBW, and perinatal
death is to promote optimal pregnancy health.
5. • Diet
• Smoking
• Alcohol use
• Substance abuse
Modifiable
• Maternal age
• Ethnicity
• Genetic inheritance,
• Preexisting health problems
Nonmodifiable
MATERNAL RISK FACTORS
Risk factors may be either modifiable or
nonmodifiable. Eg:,
6. MATERNAL RISK FACTORS
The presence of one risk factor may lead to
other risk factors causing an additive effect.
For example, a pregnant woman who lacks financial
resources might also have a poor obstetric history, an
inadequate nutritional intake, increased stress, and
nicotine addiction.
7. MATERNAL RISK FACTORS
Maternal risk factors consist of demographic,
behavioral, and psychosocial factors, as
well as maternal medical conditions and
pregnancy related conditions
Demographic risk factors include,
Ethnicity
Age
Socio economic status
Occupation, and
Environmental or work-related exposures
8. Psychosocial risk factors include
Social, behavioral, stress related or maternal
psychological conditions
Medical risk factors
The IOM categorizes medical risk factors into
immutable factors which can’t be changed and
mutable factors which can possibly be altered
9. Immutable factors include factors
which predate the pregnancy such as
Obstetric history (i.e., previous history of
infertility, PTB, or pregnancy loss)
Maternal characteristics
Short stature
Low pre pregnancy weight
Low body mass index (BMI)
Pregnancy-related conditions such as
Multiple gestation
Pregnancy-induced hypertension (PIH)
Gestational diabetes.
10. Mutable risk factors include
behavioral risk factors the mother
has either prior to or during
pregnancy that can possibly be
harmful to the fetus, such as
Inadequate dietary intake
Smoking
Substance abuse (drugs or alcohol).
11. Maternal age
The maternal age at the time of the birth
of the first child ranges from an average
of 15.5 to 20.5 years the in traditional
forager, agricultural, and horticultural
societies and from 25.1 to 29.9 years in
more developed nations
Teen pregnancy increases the risk of
adverse outcomes such as
Preterm delivery, LBW, low 5-minute Apgar
score, or early neonatal death
12. Maternal age
After birth, infants of younger mothers (<
19 years of age) had an increased risk
for readmission to the hospital within the
first 6 weeks after discharge.
There are also lifelong disadvantages for
younger teen mothers who have less
years of formal education pregnancy.
13. Maternal age
Pregnant adolescents who are uneducated most
likely will not use contraception, may not
recognize danger signs in pregnancy that
something is wrong, or may not even seek
prenatal care
14. Maternal age
Advanced maternal age refers to women who are older
than 35 at the estimated date of delivery
Advanced maternal age poses increased risks for
Decreased fertility
Chromosomal abnormalities in the infant
Spontaneous abortion
Ectopic pregnancy
Preterm delivery
Stillbirth
Late fetal and early perinatal death rates are higher
for pregnant women between ages 45 and 54 than
for any other age groups
15. Maternal age
Older pregnant women are at an increased risk
for medical problems associated with aging such
as diabetes or PIH
Advanced maternal age creates genetic risks
because as the woman gets older the genetic
material contained within her ova ages
Trisomy 21 (Down syndrome), trisomy 18, and
trisomy 13 are examples of genetic problems
resulting from errors in cell division
16. Psychological stress in
pregnancy
Stress is an interaction between the person
and environment in which there is a perceived
discrepancy between the demands of the
environment and the individual’s resources
(i.e., psychological, social, or biological) for
dealing with it
17. Psychological stress in
pregnancy
During pregnancy women may
experience many types of
stressors about
Finances
Work situations
Difficult relationships
Health concerns of self or other
family members, or other factors
Emotional stress may include
feelings of anxiety, fear, tension,
depressions, or sadness
18. Psychological stress in
pregnancy
Acute stressors can occur due to
life events such as the
death or serious illness of a loved
one.
Death of the father of the
developing fetus or of a first-
degree relative of the mother
during mid-pregnancy.
There was increased risk for
shortened gestation if the stressor
occurred in the fourth or fifth
month of pregnancy, while
vulnerability to LBW or SGA
19. Psychological stress in
pregnancy
The exact mechanism by which maternal
stress causes PTL is not fully understood, but
it is thought to occur by one of two
mechanisms.
Corticotrophin-releasing hormone released as a
by-product of maternal stress could stimulate
neuro-endocrine pathways within the maternal-
fetal-placental unit that trigger labor
Maternal stress could cause increased maternal
and fetal susceptibility to inflammation and
infection, triggering labor through an immune-
inflammatory pathway;
20. Obstetric factors
Obstetric history is a good indicator of the
presence of maternal risk factors.
Women with previous obstetric complications are
more at risk for problems with the current
pregnancy.
Previous obstetric history of infertility
Stillbirth
Preterm infant
Infant with growth restriction or congenital anomalies
Genetic problems
Complications during pregnancy or birth, or
Other poor outcomes are clues that indicate that the
pregnancy must be closely monitored.
21. Important obstetric factors that can compound
pregnancy risk are the
Adequacy of prenatal care,
The number of previous pregnancies,
Inter pregnancy level
The use of assistive reproductive
technology(ART), and
Postterm pregnancy
22. Prenatal care
Prenatal care that begins in the first trimester of
pregnancy and continues until birth helps promote
good birth outcomes
Most women seek prenatal care during the first
trimester of pregnancy
UNICEF and WHO have set a worldwide goal for
a minimum of four prenatal visits during
pregnancy
Worldwide, approximately 72% of women have at
least one prenatal visit, and 42% of women
(excluding China) have four or more prenatal
visits
23. Prenatal care
Inadequate prenatal care increases the risk for
LBW
PTB and
Perinatal death
High post neonatal death rates seen in infants
of women who did not have prenatal care
might be associated with lack of access to
care providers or lack of use of pediatric
medical care
24. Parity
Parity or number of previous deliveries is
another risk factor to consider.
Parity is difficult to disassociate from age as
women with higher parity are usually older.
The risk for having the following increases as
parity increases,
LBW infant
Preterm delivery
Abruptio placenta
placenta previa
25. Interpregnancy level
Interpregnancy level is defined as the amount of
time between delivery of a baby and the
subsequent conception of another child.
Short interpregnancy level of less than 6 months
increases the risk for maternal complications,
including
Third-trimester bleeding
PROM
Puerperal endometritis
Anemia, and
Maternal death.
26. Assistive reproductive
technology
ART is any procedure or medical
treatment used to assist a woman to
achieve pregnancy.
ART is an option for many couples who
have a history of infertility
27. Assistive reproductive
technology
ART methods include
the use of medications to stimulate
ovulation and release of eggs, or
procedures where eggs and sperm are
removed and mixed outside of the body to
achieve fertilization
ART increases the risk for
Multiple pregnancy
Prematurity, and
LBW
28. Postterm pregnancy
Postterm pregnancy is defined as a pregnancy
that continues past 42 weeks (294 days) or 14
days past the estimated due date (American
College of Obstetricians and Gynecologists
[ACOG], 2004)
Incidence is in about 7% of all pregnancies.
The cause of postterm pregnancy is not known,
but it occurs more often with
Male fetuses
Genetic basis.
Inaccurate dates used to calculate the estimated
date of confinement.
29. Postterm pregnancy
Ultrasound dating of pregnancy is
considered to be accurate if done during
the first trimester; however, ultrasound
dating of pregnancy has a margin of error.
Postterm infants are more likely to have
Macrosomia,
Prolonged labor or
Cephalopelvic disproportion (CPD) with
Increased risk for cesarean section,
Shoulder dystocia
Increased risks of possible musculoskeletal
injury
(i.e., Fractured clavicleor brachial plexus injury)
30. HCBs (health-compromising
behaviors)
HCBs such as smoking, illicit drug use, or
alcohol use can compromise overall maternal
health during pregnancy and can negatively
influence fetal well-being.
31. Smoking
Smoking is a major predictor of LBW possibly
due to impaired oxygen delivery (hypoxia) and
nutrient delivery from the mother to fetus.
Infants of mothers who smoke have an
increased risk of,
Spontaneous abortion
Late fetal death
Preterm delivery, and
Neonatal mortality
32. Substance Abuse
Substance abuse is a concern for childbearing
women of all ages.
More teenagers are experimenting with drugs,
alcohol, and smoking cigarettes and marijuana
than in the past.
Marijuana smoking results in carbon monoxide levels
five times higher than cigarette smoking, that limits
fetal growth and oxygenation
Women under the influence of mind-altering
substances are more likely to make poor choices and
have an increased risk of engaging in unprotected sex
resulting in an unplanned pregnancy
33. Substance Abuse
Maternal alcohol ingestion during pregnancy
can result in FAS.
Incidence of FAS may be related to both
environmental exposure and genetic
susceptibility.
Alcohol is believed to have a direct teratogenic
effect that limits fetal growth and brain growth.
34. Nutrition
Adequate nutrition prior to conception and
during pregnancy is important for maternal and
fetal health.
The pregnant woman needs to consume
enough calories and nutrients to meet her own
physiological needs as well as those of the
developing fetus.
35. Nutrition
Lack of adequate nutrients prior to or during
early pregnancy can lead to birth defects
Inadequate or excessive weight gain,
Medical conditions that complicate pregnancy
such as hyperemesis gravidarum
Dental conditions that compromise the ability to
take in food
Inadequate resources to access food
36. Nutrition
Another important nutritional consideration is
prevention of maternal anemia during
pregnancy. Anemia is a serious problem
affecting about half of pregnant women
worldwide.
Women who are anemic are less likely to
withstand blood loss during delivery and have
increased risks of perinatal death, LBW,
stillbirths, and prematurity (WHO, 2005)
Promoting adequate nutrition prior to
pregnancy is a key to improving outcomes of
pregnancy
37. Nutrition
Another important nutritional consideration is
prevention of maternal anemia during
pregnancy. Anemia is a serious problem
affecting about half of pregnant women
worldwide.
Women who are anemic are less likely to
withstand blood loss during delivery and have
increased risks of perinatal death, LBW,
stillbirths, and prematurity (WHO, 2005)
Promoting adequate nutrition prior to
pregnancy is a key to improving outcomes of
pregnancy
38. Nutrition
Maternal obesity is another nutritional
concern for pregnancy. Infants of obese
women (defined as BMI over 30.0 kg/m2) have
more than twice the risk for stillbirth and
neonatal death after adjusting for other factors
including smoking, alcohol, maternal age,
parity, hypertension, and diabetes
39. Nutrition
Women who ingest food contaminated with
Listeria do not usually feel ill; however, the
fetus can be significantly affected. Eating food
contaminated by microorganisms like Listeria
or substances like heavy metals can cause
abortion, stillbirth, preterm delivery, neonatal
infections, fetal brain or kidney problems, or
even maternal death.
40. Nutrition
Pica is an interesting dietary practice seen
during pregnancy in almost every culture.
Substances like starch, ice, clay, or dirt are
ingested as a craving in an attempt to possibly
increase iron or calcium intake.
Pica is not generally harmful to the fetus and
may help alleviate gastrointestinal distress in
pregnant women
The influence of cultural dietary practices as
potential risk factors can’t be ignored and
must be assessed
41. Over-the-Counter and
complementary Drugs
Drugs taken during pregnancy can have
harmful effects on the fetus whether they are
controlled substances or over the- counter
medications
Pregnant women should not take any
medications without consulting with their
health care provider,
42. Over-the-Counter and
complementary Drugs
Many pregnant women take over-the-counter
or nonprescribed medications during
pregnancy, including complementary therapies
they might not consider to be harmful
Even vitamins and dietary supplements taken
in excessive dosages can be harmful to the
fetus
43. Environmental Influences
Exposure by the mother to environmental
toxicants either before or during pregnancy
can precipitate gene–environment interactions
that can alter these molecular interactions,
especiallyb if the exposure to the harmful
substance occurs at critical periods of fetal
development.
44. Environmental Influences
Two critical periods
During organogenesis (when fetal organs are being
formed)
During the fetal period when there is rapid growth of
all systems
Spina bifida is an example of a gene–environment
interaction
Environmental hazards are found in air, water, and
food. These seemingly innocuous substances can
contain high levels of contaminants such as
pesticides, heavy metals, and solvents
45. Environmental Influences
Occurrence of natural or manmade disasters
such as hurricanes, severe ice storms,
earthquakes, chemical spills, or terrorism
Outcomes of environmental hazards exposure
can be
Increased rates of spontaneous abortion,
congenital anomalies,
decreased fetal growth, and
changes in maternal mental health status,
PTB
46. Other Emerging Risk Factors
Other risk factors that may affect perinatal
outcomes are constantly under investigation.
Recently, obesity has been identified as an
emerging risk factor for PTB
Severe maternal snoring and maternal sleep
deprivation in the last trimester of pregnancy
have been linked to an increased risk for fetal
growth restriction or LBW
47. Maternal medical and
obstetric conditions
Diabetes, hypertension, and bleeding
disorders are some of the most common
maternal complications of pregnancy
worldwide
These complications can lead to preterm
delivery, perinatal death, or can influence fetal
morbidity. Risk of maternal complications of
pregnancy increases with advanced maternal
age
48. Diabetes
During pregnancy, regulation of blood glucose
is sometimes difficult since pregnancy creates
a state of insulin resistance and insulin needs
change with each trimester.
49. Diabetes
Glycosylated hemoglobin levels (HbA1c)
should be maintained to as close to normal
range as possible during pregnancy, especially
during the period of fetal organogenesis
About 5% of pregnancies are complicated by
gestational diabetes
50. Diabetes
All pregnant women should be screened for
gestational diabetes through patient history,
presence of clinical risk factors, or
administration of a 50 g 1-hour oral glucose
tolerance test (OGTT) between 24 and 28
weeks gestation
The ADA recommends a 75-g OGTT at 24 to
28 weeks with blood glucose measurement
when fasting, and at 1 and 2 hours after blood
glucose administration.
51. Diabetes
Infants of diabetic mothers generally have
Macroso mia
Increased risks for birth injuries due to shoulder
dystocia, including fractured clavicles or nerve
palsies.
Large infants are more likely to be delivered by
cesarean section.
Infants of diabetic mothers should be closely
monitored for hypoglycemia in the immediate
postbirth period and until feeding is well
established
52. Hypertension in Pregnancy
Approximately 6% to 8% of
pregnancies are complicated by
hypertensive disorders
The national high blood
pressure education working
group defined four categories of
hypertension in pregnancy:
Chronic hypertension,
Gestational hypertension,
Preeclampsia, and
Preeclampsia superimposed on
chronic hypertension
53. Hypertension in Pregnancy
Hypertension in pregnancy causes
vasoconstriction with subsequent poor
maternal circulatory and placental perfusion
Decreased utero-placental circulation
compromises the fetus; therefore, it is more
likely to be growth restricted, SGA, or at
increased risk for stillbirth
54. Hypertension in Pregnancy
Women with PIH are also at increased risk for
abruptio placenta
Early delivery will be based upon stability of the
mother and outcomes of fetal testing.
A serious risk for the preeclamptic mother is the
possibility of eclamptic seizures due to cerebral
edema and central nervous system excitability or
progression to the HELLP syndrome
55. Hypertension in Pregnancy
If the mother’s condition worsens, early
delivery will be elected; however, the ability of
the fetus to survive must be considered
Corticosteroid administration is advised and
may be beneficial if the fetus is between 24
and 34 weeks gestational age and if the
mother has never had them
56. PROM
PROM is a cause of preterm delivery and
occurs in about 3% of all births
Once the membranes rupture, the fetus is at
high risk for problems related to
oligohydramnios, cord compression,
chorioamnionitis, and abruptio placenta
57. PROM
About 13% of pregnancies complicated with
PROM develop chorioamnionitis.
Signs of intrauterine infection include fever
greater than 100.4°F (38.0°C), uterine
tenderness, and maternal or fetal tachycardia.
antibiotic therapy has been demonstrated to
lower the number of infants with respiratory
distress syndrome, death, early sepsis, severe
intraventricular hemorrhage, and severe
necrotizing enterocolitis.
58. Maternal Infections
Women may be infected prior to pregnancy or
acquire the infection during pregnancy
Maternal infections can be transmitted to the
infant while in utero across the placenta,
during the birth process, or even during the
postpartum period.
59. Maternal Infections
Fetal infections can cause congenital
anomalies, LBW, respiratory illness after birth,
or even death. Infectious agents include
protozoal infections, helminthic infections,
sexually transmitted diseases (STDs), viruses,
and bacterial organisms.
60. Maternal Infections
Every pregnant woman must be screened for
risk factors for infection. Early identification
and treatment of women with infections will
improve both maternal and neonatal outcomes
61. Abruptio Placenta
Abruptio placenta, or premature separation of
the placenta prior to delivery, is a leading
cause of stillbirth and neonatal mortality
Placental separation is thought to be due to
Changes in placental vasculature,
Thrombosis, and
Reduced placental perfusion.
62. Abruptio Placenta
Perinatal death from abruptio placenta is
higher for singletons than for multiples,
possibly due to IUGR, chronic fetal
compromise, LBW, or blood loss from the
abruption, while in multiples a different etiology
could be a factor
63. Postpartum risk factors
After birth, the five leading causes of infant
death are
complications of congenital anomalies,
complications of prematurity
LBW,
SIDS,
result of maternal complications, and
placental-cord complications
64. Drugs Excreted in Maternal
Milk
Maternal medications taken while lactating are a
concern as they may alter the milk supply or
cross to the infant though the milk supply
Psychotropic drugs pose a special concern
since there has been an increase in their use.
These drugs and their metabolites have long
half-lives and are detectable in infant tissues
and the developing brain
65. Drugs Excreted in Maternal
Milk
Some untoward effects on the
infant from use of prescribed
maternal drugs include,
Immune suppression,
Neutropenia,
Skin rash,
Central nervous system changes
including irritability, restlessness,
sleepiness, lethargy, or convulsions,
Gastrointestinal effects such as
feeding problems, vomiting,
diarrhea, slow weight gain, blood in
stool, jaundice, or dark urine.
66. Sudden Infant Death
Syndrome
SIDS is the leading cause of death in infants in
the postneonatal period in the United States
as well as other developed countries
Programs such as the AAP Back to Sleep
campaign urged parents to place their infants
on their backs instead of prone for sleeping
67. Sudden Infant Death
Syndrome
SIDS has been blamed on environmental
factors such as
Soft bedding,
Overheating,
Entanglement in blankets,
Immunizations,
Tobacco smoke exposure, or
Bed sharing with parents or siblings, especially if
a bed partner consumes alcohol
68. Sudden Infant Death
Syndrome
Nurses need to educate parents to share
information with their childcare providers about
placing the baby on the back to sleep
Neonatal nurses must continue to educate
each parent about the risk factors for SIDS
and remind parents that the safest place for a
baby is in its own crib in the parents’ room for
the first 6 months.
69. Child Abuse
Child abuse in infants is sometimes difficult to
identify
Parents of an injured infant arrive for
emergency treatment and seem severely
distraught and worried about their child’s
injuries
70. Child Abuse
They often offer reasonable explanations for
the injury that must be ruled out with medical
tests
New parents are subject to many stressors
that could trigger child abuse such as lack of
sleep, financial strain, and dealing with
inconsolable infants
71. Child Abuse
Health care providers have a legal and ethical
duty to report cases of suspected child abuse
to child protective service
Two forms of child abuse are discussed
further:
Abusive head trauma (AHT), formerly called
shaken baby syndrome (SBS), and
Munchausen syndrome by proxy (MSBP).
72. Abusive Head Trauma/Shaken
Baby Syndrome
AHT describes a serious form of head trauma
caused by several mechanisms including
abusive shaking of an infant causing a
whiplash-type injury, blunt trauma, or a
combination of both
73. Abusive Head Trauma/Shaken
Baby Syndrome
Several types of injuries occur with AHT/SBS.
Intracranial injuries cause direct brain injury
and damage to the axons
Shearing forces exerted on the veins that
bridge from the dura to the brain cause
intracranial bleeding
74. MSBP
MSBP is a rare form of child abuse where a
parent, usually a mother, fabricates illness in a
dependent child in order to draw attention to
themselves as the parent of a sick child.
75. MSBP
Four criteria are required for a diagnosis:
A parent or guardian fabricates illness in the child,
The child is presented for medical care,
The perpetrator denies knowledge of the cause of
the child's illness, and
The signs and symptoms subside if the child is
separated from the perpetrator
76. MSBP
Some of the most common types of
fabrications include
Gastrointestinal (diarrhea), neurologic
(seizures), infections (fevers), dermatologic
(strange rashes), and cardiopulmonary (acute
lifethreatening events).
77. Conclusion
This session has presented an overview of
some of the many prenatal, intrapartum, and
postpartum risk factors that influence neonatal
health, especially in relation to prematurity and
LBW. The perinatal nurse must be aware of
potential risk factors in order to screen
pregnant women and provide counseling and
support.