High- Risk Newborm

1. Preterm Infant
Pathophysiology:
A specific pathogenic process of premature delivery represents the inflammation. Birth canal infections
seem to play a key role in the ethiopathogenesis of premature delivery; the related biochemical changes
significantly affect perinatal morbidity and mortality.
Symptoms:

 Sharper looking
 less rounded features than a full-term baby's features
 due to a lack of fat stores.
 Low body temperature
 Anemia
 Breathing problems
Treatments:

 Surfactant, a medication used to treat respiratory distress syndrome.

 Fine-mist (aerosolized) or IV medication to strengthen breathing and heart rate.
 Antibiotics if infection is present or if there's a risk of possible infection.
 Medicines that increase urine output (diuretics) to manage excess fluid.
Causes:

 tobacco use
 substance abuse
 short time (less than 18 months) between pregnancies.
Risk Factors:

 Prior premature birth

 Poor nutrition
 Chronic high blood pressure
 Heart disease
https://www.healthline.com/health/pregnancy/premature-infant#prevention

2. SGA- Small for Gestational Age

Pathophysiology:
defined as a birth weight of less than 10th percentile for gestational age. The burden of fetal growth-
restricted (FGR) SGA is higher in resource-poor countries, and children born FGR SGA have a higher
risk of mortality and morbidity during the neonatal period and beyond.
Symptoms:

 Lower oxygen levels than normal

 Low Apgar scores.
 Breathing in the first stools (meconium) passed in the womb. This can cause breathing problems.
 Low blood sugar
Treatment:

 Temperature controlled beds or incubators.

 Tube feedings (if the baby does not have a strong suck)
 Checking for hypoglycemia (low blood sugar) through blood tests.
 Monitoring of oxygen levels.
Causes:
 Maternal factors: High blood pressure. Chronic kidney disease.
 Factors involving the uterus and placenta: Decreased blood flow in the uterus and placenta.
 Factors related to the developing baby (fetus): Multiple gestation (for example, twins or triplets)
 Cigarette smoking
 Cocaine use
Risk Factors:
 Hypertension
 renal disease
 anti-phospholipid syndrome
 Malaria
  High blood pressure (hypertension)
 Long-standing
  diabetes
 Chronic kidney disease
https://www.msdmanuals.com/home/children-s-health-issues/general-problems-in-newborns/small-for-
gestational-age-sga-newborn

3. LGA- Large for Gestational Age

Pathophysiology:
Large for gestational age (LGA) refers to a fetus or infant who is larger than expected for their age and
gender. It can also include infants with a birth weight above the 90th percentile. The LGA measurement is
based on the estimated gestational age of the fetus or infant.
Symptoms:

 Birth injuries 
 Difficult delivery:Vaginal delivery
 Lung problems
 Low blood sugar (glucose) levels (hypoglycemia)
 Birth defects
Treatment:

  mechanical ventilator
Causes:

 Gestational diabetes
 Obese pregnant mother
 Excessive weight gain during pregnancy
Risk Factors:

 Previous multiple induced abortions or spontaneous miscarriages

 Heart disease
 High blood pressure
 Kidney disease
 Diabetes
 Preeclampsia or eclampsia

https://www.msdmanuals.com/home/children-s-health-issues/general-problems-in-newborns/
premature-newborn

4. Respiratory Distress Syndrome

Pathophysiology:

marked by inflammation-mediated disruptions in alveolar-capillary permeability, edema formation,

reduced alveolar clearance and collapse/derecruitment, reduced compliance, increased pulmonary
vascular resistance, and resulting gas exchange.

Symptoms:

 Fast breathing very soon after birth.

 Grunting “ugh” sound with each breath.
 Changes in color of lips, fingers and toes.
 Widening (flaring) of the nostrils with each breath.
 Chest retractions - skin over the breastbone and ribs pulls in during breathing.

Treatment:

 Surfactant - Surfactant can be given into the baby's lungs to replace what they do not have
 Intravenous (IV) catheter treatments - A very small tube called a catheter, is placed into one or
two of the blood vessels in the umbilical cord.
Causes:

 Sepsis. The most common cause of ARDS is sepsis, a serious and widespread infection of the
bloodstream.
 Inhalation of harmful substances.
 Severe pneumonia.
 Head, chest or other major injury.
 Coronavirus disease 2019 (COVID-19).
Risk Factors:

 cesarean section
 severe birth asphyxia
 PROM
 male sex
 gestational glucose intolerance or diabetes
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4115996/#:~:text=The%20results%20of%20this
%20study,RDS%20in%20full%2Dterm%20neonates.
5. Meconium Aspiration Syndrome
Pathophysiology:
occurs when a newborn breathes a mixture of meconium and amniotic fluid into the lungs around the time
of delivery. Meconium aspiration syndrome, a leading cause of severe illness and death in the newborn,
occurs in about 5 percent to 10 percent of births.

Symptoms:
 Bluish skin color in the infant.
 Breathing problems.
 Dark, greenish staining or streaking of the amniotic fluid or the obvious presence of meconium
in the amniotic fluid.
 Limpness in infant at birth.
Treatment:
 oxygen therapy to make sure there is enough oxygen in the blood.
 the use of a radiant warmer to help your baby maintain body temperature.
 antibiotics such as ampicillin and gentamicin to prevent or treat an infection.
 the use of a ventilator (a breathing machine) to help your infant breathe.

Causes:

 the baby's first stool (feces)

 when a baby is stressed and gasps while still in the womb, or soon after delivery when taking
those first breaths of air. When gasping, a baby may inhale amniotic fluid and any meconium in
it. Babies are more likely to pass meconium when: They've had a long or hard delivery.
Risk Factors:

 Diabetes or high blood pressure in the mother.

 A long or difficult labor or delivery.
 Decreased oxygen to the infant while in utero.
 Poor intrauterine growth.
https://familydoctor.org/condition/meconium-aspiration-syndrome-mas/

6. Hyperbilirubinemia Rh Incompatibility/ ABO Incompatibility

 Pathophysiology:
The sensitization of the mother depends on multiple factors, including the volume of transplacental
hemorrhage, the extent of the maternal immune response, and the concurrent presence of ABO
incompatibility. It affects 17% of pregnant women with 1mL of Rh-positive cells and 70% after
250mL of rhesus-positive cell exposure
Symptoms:

 Jaundice
 Anemia

Treatment:

 Extra feedings
 Phototherapy
 Blood transfusion

Causes:
Blood type is based on genes from each parent. So if one parent is type O and one is type A, the baby will
likely be type A.6 The reason the baby wouldn't have type O blood is because the gene for O is recessive
(meaning it's only expressed if the baby gets it from both parents).

The four blood types are A, B, AB, and O. Blood type is determined based on proteins on the surface of
red blood cells. These proteins are potential antigens—substances the immune system doesn't recognize.
The immune system creates antibodies to fight off the unfamiliar protein. These antibodies can cross the
placenta, where they break down the baby's red blood cells after birth.

Risk Factors:

 Brain damage due to high levels of bilirubin (kernicterus) 

 Fluid buildup

 swelling in the baby (hydrops fetalis) 

 Problems with mental function

 Movement

 Hearing

 Speech

 seizures.

https://www.verywellfamily.com/abo-incompatibility-2634457#toc-treatment