HIGH-RISK NEWBORNS: EXPLAINED

High-risk newborns are generally the result of a gestation period that has been affected by various harmful medical or physical determinants. They usually are linked with mothers who suffer from one or more type of illnesses or practice unhealthy lifestyles post conception. High-risk newborns are susceptible to higher chances of morbidity and mortality compared to normal infants, the first month after delivery being the most crucial one. Such children are prone to symptoms of immaturity, congenital anomaly & various complications during birth.

High-risk newborns are categorized on the basis of their respective gestation periods

  • Pre-Term Infants are born before the traditional nine-month period (37weeks).
  • Term Infants come out after an additional delay of nearly 45 days (38-42weeks).
  • Post-Term Infants are born after the tenth month, roughly after 42 weeks of gestation.

FACTORS THAT PROMOTE THE BIRTH OF HIGH RISK NEWBORNS

 MATERNAL FACTORS :

Social & Demographic Reasons –

  • Conception before 16 years of age can lead to the possibility of birthing premature high risk newborns highly likely to suffer from Intrauterine Growth Retardation (IUGR). Pregnancy after 40 leads to chromosomal anomalies in the fetus, blood loss & birth of larger than average infants.
  • If the mother is subjected to abject poverty, her malnutrition during pregnancy increases the chances of the fetus contracting infections, IUGR, even fetal demise in extreme cases.
  • Exposure to drugs & smoking increases the fetus’ prenatal mortality & causes fetal alcoholic syndrome, withdrawal syndrome & sudden infant death syndrome.

Medical Reasons –

  • Mothers diagnosed with Diabetes Mellitus are highly likely to give birth to infants with congenital anomalies who suffer from hypoglycemia, respiratory distress syndrome & even stillbirth.
  • Mothers with thyroid & renal diseases pass on goiter, hypothyroidism, hyperthyroidism, IUGR and prematurity to their fetuses.
  • Mothers suffering from heart or/and lung diseases run the risk of delivering premature, stillbirth babies.
  • Urinary Tract Infection detected in the mother leads to prematurity and sepsis in the baby.

Previous Pregnancy Experiences –

  • Mothers with past history records of giving birth to infants suffering from jaundice, medical anomalies or prematurity run the chance of encountering the same situation with the present pregnancy.
  • Bleeding in early pregnancy or third semester indicates high chances of stillbirth, prematurity & anemia. Premature rupture of the membrane leads to infections as well.
  • If the mother suffers from trauma or hyperthermia, it results in stillbirth.
  • The occurrence of neonatal death in the previous pregnancy increases the chances of giving birth to a high risk newborn yet again.

 FETAL FACTORS : 

  • Twin-to-Twin Transfusion Syndrome leads to abnormal blood flow to the twins sharing the same placenta, leading to birth trauma.
  • Development of Intrauterine Growth Retardation in the fetus leads to congenital anomalies, asphyxia & hypoglycemia.
  • Abnormal positioning of the fetus inside the womb can lead to birth trauma & hemorrhage. The baby’s decreased activity indicates asphyxia or possible fetal demise.
  • Fetus’ irregular heartbeat indicates congestive heart failure or block, asphyxia or hydrops.
  • The excessive amniotic liquid in the sac (Polyhydramnios) leads to central nervous system disorders in the fetus, cardiac failures, tumors, inability to concentrate urine, diaphragmatic hernia, chylothorax, difficulty with swallowing, and more.
  • In case of Oligohydramnios, there occurs a deficiency of the amniotic fluid inside the sac which leads to placental insufficiency, pulmonary hypoplasia, deformations, renal agenesis, and even fetal demise.

LABOR RELATED FACTORS : 

  • Preterm delivery of infants leads to surfactant deficiency in their bodies causing distress during the process of respiration.
  • Postterm infants are more likely to be stillbirths or suffer from asphyxia or meconium aspiration.
  • Childbirth during maternal fever or maternal hypertension increases the chances of sepsis and asphyxia.
  • Prolonged & rapid labor sessions induce birth trauma, increase the possibility of intracranial hemorrhage, and may result in stillbirth in extreme cases.
  • Cases that register of meconium-stained amniotic fluid cause’s meconium aspiration syndrome and persistent pulmonary hypertension.
  • Cesarean Section deliveries run the risk of inflicting the infant with Respiratory Distress Syndrome, hypothermia & hypotension.
  • Attachment of abnormal blood vessels to the placenta or a torn placenta leads to imminent blood loss. The large size of the placenta leads to formation of a large infant and small placentas cause Intrauterine Growth Retardation.

POST BIRTH (NEONATAL) FACTORS : 

  • The emergence of a premature baby during delivery indicates possibility of contraction of Respiratory Distress Syndrome within the incoming 28 days period.
  • Foul smelling amniotic fluid or/membranes indicate infection.
  • Infants weighing less than 2000 grams or exceeding 4000 grams upon birth increases their chances of contracting congenital malformations.
  • Infants are registered to be suffering from Post Maturity Syndrome if they have visibly dry peeling skin after delivery, has thick hair growth & overgrown nails.
  • During the conduction of the Apgar test 5 minutes after birth, if the infant scores low, it indicates that he is at a 20-fold to 100-fold increased risk of cerebral palsy than an infant who scores 7 to 10.
  • If the infant continues to score low in the re-conduction of the Apgar test 15 minutes post birth, then the baby runs high risk of suffering from long-term neurological damage.

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