CLASSIFICATION OF NEW

BORN

5/17/2017 By, Hiwot T. 1

 Classification of a Newborn
1. Gestational Age:

Preterm (<37wks)
Term (37-42wks)
Postterm (>42wks)
2. Birth Weight:

Very low birth weight: <1500gm

Low Birth weight: <2500gm
Normal BW: 2500-4000gm
Macrosomia: >4000gm

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Newborns are also classified by comparing the birth weight and
gestational age.
A newborn is classified as:
Appropriate for gestational age (AGA) if the birth weight lies between 10%-
90% for the specified gestational age
Large for gestational age (LGA) if the weight lies above 90% for the
specified gestational age.
the newborn has a high weight for gestational age.
Small for gestational age (SGA) if the weight lies below 10% for the
specified
gestational age
the infant has a low weight for gestational age. Intra uterine growth is
retarded

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 SGA: <10th%ile,
AGA: Between 10th and 90th %ile,
LGA: >90th%ile

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Prematurity

The length of normal pregnancy or gestation is considered to be 42 weeks from

the date of conception
Infants born before 37 weeks gestation are considered premature
• May be at risk for complications

What causes prematurity?

• There are many factors linked to premature birth.
• Some directly cause early labor and birth, while others can make the mother or
baby sick and require early delivery.

The following factors may contribute to a premature birth:

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Maternal factors:

◦ preeclampsia
◦ chronic medical illness (such as heart or kidney disease)
◦ infection ( infections of the fetal/placental tissues)
◦ cervical incompetence (inability of the cervix to stay closed during
pregnancy)

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 Cont….
FETAL
Fetal distress

Multiple gestation

PLACENTAL
Placenta previa
Abruption placenta

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 problems associated with prematurity

RESPIRATORY
Respiratory distress syndrome (hyaline membrane disease) a
condition in which the air sacs cannot stay open due to lack of
surfactant in the lungs.
Apnea (cessation of breathing >15sec)
Pneumothorax
Pulmonary hemorrhage

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cardiovascular:
◦ patent ductus arteriosus (PDA) - a heart condition that causes blood to
divert away from the lungs.
◦ low heart rate - often occurs with apnea

blood and metabolic:

◦ anemia - may require blood transfusion
◦ jaundice - due to immaturity of liver and gastrointestinal function
◦ immature kidney function

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gastrointestinal:
 difficulty feeding - many are unable to coordinate suck and swallow before
35 weeks gestation
 poor digestion
 necrotizing enterocolitis (NEC) - a serious disease of the intestine
neurologic:
 intraventricular hemorrhage - bleeding in the brain
 poor muscle tone
 seizures - may be due to bleeding in the brain
 retinopathy of prematurity - abnormal growth of the blood vessels in a
baby's eye.

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 The Post-term infants

• Definition : Are infants born after 42 weeks of gestational age

Epidemiology : 4-14%
cause
Unknown
Wrong dates
Irregular ovulation

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Post term infants
C/M
• Absence of lanugo
• Desquamated , dry, cracked skin
• Long and curved nails
• Abundant scalp hair
• If placenta insufficiency occurs –loose skin ,growth retarded ,meconium stained

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Post term infants
Complications
• Meconium aspiration
• Hypoglycemia
• Polycythemia
• Pulmonary hemorrhage
• Pneumonia
• Pneumothorax and problem associated with asphyxia

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Post term
Mx /care
• Careful ANC surveillance
• Induction of labor or CS
• For meconium aspiration suctioning should be done
• Medical problems in the newborn are treated if they arise.

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Care of the Post-term Newborn

Assess the newborn for post maturity syndrome

• Usually long and thin ( old man looking)
May require prolonged monitoring and support of well-being due to
wasting effect
Early detection of polycythemia and hyperbilirubinemia

Attention to proper nutritional support.

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 Thank you

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