Preterm and Very Preterm babies

BabyRN2Be · Mar 25, 2006

Hi Dean!

Wow! You're story sounds so incredible. It's so wonderful that you didn't have any cognitive or physical disabilities which so often happens with preterm babies.

Although I don't have any answers for you right now, I think I know of a place which might be able to help you here at allnurses (btw, WELCOME to Allnurses.com! )

There is a forum for Neonatal Intensive Care Nursing. It's under the "Critical Care forums." Follow the "Critical care" forum links and you'll find NICU nursing. They have a lot of information over there. If you don't find what you are looking for, you can go ahead and post over there and someone will help you out.

Hope you find what you are looking for!

krobi78527 · Mar 25, 2006

Hi! Sounds like things turned out well for you. I can tell you that you are very fortunate. It is a known issue that in "general" premies have a tendency to have slower physical/mental development. Learning disabilities are also more common. In fact, the military has a special program that follows premies from birth through elementary school that follows these kids and offers testing and resources because they do frequently have problems. But no one knows why some kids do great and others are delayed. I have no hard research to point to, I am just familiar with the military interventions.

LydiaNN · Mar 25, 2006

i just had to look these numbers up for a grant i wrote for work. since i was working on it from the office, i don't have the file with the source, but if you need it, i could post it on monday.

neurodevelopmental morbidity in infants with birth weights less than 1500 g

incidence of a disability (range)
- none (35-80%)
- mild-to-moderate (8-57%)
- severe (6-20%)
[*]type of disability (range)
- mental retardation (10-20%)
- cerebral palsy (5-8%)
- blindness (2-11%)
- deafness (1-2%)

VickyRN, MSN, DNP, RN · Mar 25, 2006

Some facts from my Neonate with Stressors lecture:

Classification of newborns by birth weight:

Low birth weight (LBW): infants weighing less than 2,500 g (5 lb, 8 oz) at birth.

Very-low-birth-weight (VLBW): infants weighing 1,500 g (3 lb, 5 oz) or less at birth.

Preterm (premature): An infant born before beginning of 38 weeks gestation or a birth at less than 37 completed weeks of gestation.

Incidence: Prematurity affects more than 460,000 infants born in the U.S. each year, or 1 of every 8 babies (12%). Prematurity is the largest cause of perinatal morbidity and mortality in the world. It remains the second leading cause of infant mortality in the United States and the first leading cause of infant death among African-American babies. Prematurity and its complications cause about 20% of neonatal deaths. The rate of premature birth is up 27% since 1981.

Etiology: Exact cause unknown. Higher risk with previous premature baby (20-40% chance) and multiple gestation pregnancies (twins, triplets, etc.). Other risk factors: placental malfunctions (placenta previa, abruptio placentae); infections (urinary tract infections, trichomonas, bacterial vaginosis); diabetes; high blood pressure/ preeclampsia; smoking or use of illicit drugs; malnutrition; not having adequate prenatal care; high maternal age, maternal stress; and depression. Periodontal (gum) disease has also been linked to preterm births.

Clinical Picture: The preterm infant lacks maturity. Organs are not developed and the baby will have difficulty adjusting to extrauterine life because of underdeveloped tissues and organs. She may have difficulty breathing and with body temperature regulation, and may lack energy for feeding. The more mature the baby is at birth, the more likely that she will not have any problems.

Survival and Disability: The earlier a child is born, the more likely he or she is to die. Babies born at less than 23 weeks of gestation are usually not mature enough to survive. Only 5 to 10 percent of babies born at 23 weeks of pregnancy survive, while about 50 percent of babies born at 24 weeks survive.

Babies born at 23 - 25 weeks are at high risk for serious, lifelong health consequences (such as mental retardation, developmental delays, cerebral palsy, lung and gastrointestinal problems, and vision and hearing loss). These babies require prolonged care in a neonatal intensive care unit (NICU), which has specialized staff and equipment that can deal with the multiple problems they face.

The survival rate increases with gestational age. The survival rate at 27 weeks is at least 80% with a disability rate of 10-15%. By 33 weeks survival is better than 95% with a disability risk of 5%. At 34 weeks, survival rates are about 99% with a disability risk similar to full-term babies.

Excellent evidence-based source of information on prematurity (a must-read):

Handbook of Neonatal Intensive Care (5th ed.). St. Louis: Mosby

Interesting links:

http://nursing.iupui.edu/LifelongLearning/default.asp?/LifelongLearning/ProgramsAndConferences/FIPSE/NeonateIntensive.htm

http://www.emedicine.com/ped/topic2600.htm

http://www.emedicine.com/PED/topic2767.htm

http://www.emedicine.com/ped/topic2784.htm

fergus51 · Mar 25, 2006

You were a BIG 26 weeker too... If you came to our unit we would question your gestational age based on that alone. Glad the docs predictions were wrong about you:)

RN4NICU, LPN, LVN · Mar 25, 2006

You were a BIG 26 weeker too... If you came to our unit we would question your gestational age based on that alone. Glad the docs predictions were wrong about you:)

That's what I was thinking too. Almost 3 pounds would be one HUGE 26 weeker!