Definition of prematurity
Gestational age < 37 weeks or weight below 2500 grams
Major risk factors for prematurity
- premature rupture of membranes
- intrauterine infection
- abnormalities of uterus, cervix
- multiple gestation
Risk factors for prematurity
- Fetal factors : chromosomal disorders, abnormalities
- Maternal factors : disease, smoking, malnutrition
- Placental factors
How many RDS/year in the US?
24,000 cases / year
How does the # of weeks of gestation affect probability for IRDS?
- 60% of infants born <28 weeks
- 30% of infants born between 28-36 weeks
Factors that increase risk for IRDS (3)
- Male gender
- Maternal diabetes
- C section
Main defect in IRDS?
Inability of immature lung to produce surfactant causes atelectasis
Hormones that regulate surfactant synthesis?
- corticosteroids increase production
- insulin decreases production
Why are C section babies more at risk of IRDS?
because labor increases surfactant production
Prevalence of necrotizing enterocolitis
1/10 of every low birth weight infants
Which organs are involved in nec enterocolitis? (3)
- Terminal ileum
- Cecum
- Right colon
What happens in necrotizing enterocolitis? (3)
- Involved segments are distended, fibrotic, and congested or gangrenous
- Bloody stool
- Abdominal distention
Definition of SIDS
Sudden death of an infant under 1 year of age, which remains unexplained after a thorough investigation
What is the triple risk model for SIDS?
- Vulnerable infant
- Critical developmental period in homeostatic control
- 1+ exogenous stressors
Most likely hypothesis for SIDS?
delayed development of arousal and cardiorespiratory control
Exogenous stressors that affect SIDS? (3)
- prone sleep position
- sleeping on a soft surface
- hyperthermia
Most common morphological findings in SIDS?
- Petechiae on thymus, pleura and epicardium
- Congested lungs
- Vascular engorgement
Effects of ventilator use in infants with IRDS (2)
Retinopathy and bronchopulmonary dysplasia
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