Characteristics of Full-Term and Premature Infants

Characteristics of Full-Term and Premature Infants

1. Gestational Age and Classification of Infants:

• Neonatal period: From 0 – 28 days of age.

• Perinatal period: From the 22nd week of gestation to 7 days of age.

2. Determining Gestational Age:

• Last menstrual period (LMP).

• Ultrasound at 10-12 weeks.

• Measurement of uterine height.

• Based on external features.

3. Classification of Infants:

• Full-term infant: From 37 – 42 weeks (278 + 15 days).

• Premature infant: Less than 37 weeks, viable. Infants > 22 weeks and weighing at least 500g.

• Post-term infant: More than 42 weeks (294 days).

• Average full-term infant: Around 40 weeks.

4. Early and Late Neonatal Diseases:

• Early neonatal: Related to the mother and childbirth.

• Late neonatal: Due to nutrition, care, and environment.

5. Respiration in Infants:

• Surfactant: Secreted from the 20th-22nd week of gestation.

• Pressure of the first cry: Approximately 45cmH2O.

• Characteristics of respiration in newborns: Rapid breathing in the first 1-2 hours, then stabilizes at 40-60 breaths/minute, reaching about 20-25cm water.

• Two pathways for alveolar fluid drainage: Absorption through blood vessels and lymph, through the airways due to chest compression.

• Respiratory irregularities in preterm infants: Lasts 2-3 weeks, possibly longer.

6. Cardiovascular System in Infants:

• Heart rate: Depends on breathing rate.

• Infant prognosis: Based on heart rate.

• Fragile blood vessels: Due to the lack of carboxylic esterase. High oxygen levels above 150mmHg cause vascular damage, especially retinal and pulmonary vessels.

• Cardiovascular characteristics: Large EKG, chest-to-heart ratio of 0.55, right axis deviation, blood pressure of 50-70mmHg.

• Fragile vessels in preterm infants: Periventricular region due to less cushioning tissue.

7. Blood in Infants:

• What type of anemia is common in preterm infants?: Iron deficiency anemia.

8. Nervous System in Infants:

• From which month of pregnancy does the nervous system develop?: The 2nd month.

• Factor affecting early development of the nervous system: Folic acid.

• Characteristics of the nervous system in full-term infants: Excitation, spreading stimulation, strong subcortical and spinal cord activity, quick movement of limbs, no orientation, startled.

• Nature of wrinkles and number of brain cells in full-term infants: Fewer wrinkles in the brain, a higher number of brain cells than older children.

• Albumin in cerebrospinal fluid is higher in older children or infants: Higher in infants due to reduced vascular permeability.

• Six characteristics of the nervous system in preterm infants:

• Which tissue has more water?

• Which gyrus is not yet formed?

• Three unclear sulci, wrinkles?

• Four cerebral cortex not active, infant restless, does not calm down, shallow breathing?

• Five weak newborn reflexes?

• Six high central venous pressure, lack of metabolic energy leads to hemorrhage?

9. Liver in Infants:

• In preterm infants, the left liver is larger than the right liver: Incorrect, it’s unclear whether this is a fetal period.

• The liver accumulates glycogen from which week?: The 35th week.

10. Digestive System in Infants:

• Characteristics of the digestive system in preterm infants:

• One is an underdeveloped digestive system, fewer digestive enzymes.

• Two is weak sucking reflex.

• Three is a small stomach, 5-10ml capacity, easy stomach dilation causing vomiting, so feed frequently.

• Four is no phenomenon of the right liver being larger than the left liver, and there is little or no glycogen, making hypoglycemia easy.

• Five is the liver doesn’t produce CA enzyme, glucoronyl transferase, causing easy hemolytic jaundice.

11. Kidneys in Infants:

• Three characteristics of the fetal period kidneys:

• One is the kidneys have no function in maintaining homeostasis.

• Two is homeostasis is maintained by the placenta.

• Three is urine production at 28ml/h after birth.

• Kidney characteristics after birth:

• One is the glomerular filtration rate of 17.

• Two is tubular function: normal dilution, decreased concentration, normal acidification, normal water and salt balance.

• Kidneys in preterm infants:

• Poor filtration and excretion function, leading to easy edema. Sensitivity to electrolytes and toxins, be careful with medication use.

12. Nutrition in Infants:

• Differences between breastfed infants, formula-fed infants, and preterm infants:

• Breastfed infants receive a relatively complete supply of electrolytes.

• Formula-fed infants have non-physiological Ca/P ratios and lack vitamin D.

• Preterm infants require additional iron and vitamin D2.

13. Supplementation of Sodium, Potassium, Iron, and Vitamins in Preterm Infants:

• Electrolytes Na, K: Similar to full-term infants, but potassium excretion is slower.

• Vitamins: Supplementation is necessary from day one.

• Iron: Primarily supplied during the last three months of pregnancy, so iron supplementation is needed two weeks after birth.

14. Touch in Infants:

• Tactile organs develop during pregnancy: True.

15. Hearing in Infants:

• What should be considered when the Moro reflex is negative? Deafness.

16. Sight in Infants:

• The eyeball is absolutely large, the optic nerve is not developed, at the end of the first month, they can see their mother, the lacrimal gland is not developed, so sometimes there are no tears: Incorrect, the eyeball is relatively large.

17. Temperature in Infants:

• At birth, heat comes from adipose tissue through a central nervous system mechanism mediated by adrenaline: True.

• Three pathways of heat loss:

• One is convection.

• Two is radiation.

• Three is water loss through skin and respiratory tract. Infants with low weight loss 50-60ml/kg/day, preterm infants over 34 weeks 15-20ml/kg/day.

18. Endocrine Gland Activity in Infants:

• Pituitary gland, pancreas, adrenal glands function immediately after birth: Incorrect, only the anterior pituitary and pancreas function immediately after birth, including in preterm infants. The adrenal glands only function early.

19. Thyroid Gland Activity in Infants:

• The thyroid gland functions from the third month of fetal life, secreting thyroxine from the 6th to 8th month. After birth, cold temperatures increase thyroxine secretion, this ability is poor in preterm infants: True.

20. Three Physiological Phenomena:

• Physiological jaundice, physiological weight loss, physiological sexual changes.

21. Causes of Physiological Jaundice:

• Red blood cell rupture due to polycythemia and Hbf, liver function, vascular permeability.

22. Characteristics of Physiological Weight Loss:

• Occurs on the second day, peaks on the 10th day, less than 10%, not accompanied by fever, there are attempts to refuse feeding, vomiting, rapid recovery over 600 grams at the end of the neonatal period.

23. Three Types of Weight Loss:

• Weight loss in the first week then increases, weight loss in the first 3-4 days then gradually increases, then a second collapse followed by gradual increase, slight weight gain after weight loss then weight gain again.

24. Physiological Sexual Changes in Male Infants:

• Breast swelling, not red, round, soft, not palpated frequently, maintain hygiene, 10-15 days, self-resolve, no treatment required.

25. Physiological Sexual Changes in Female Infants:

• Discharge of a few drops of vaginal blood, not a lot, no bleeding elsewhere, 1mg intramuscular injection, self-resolves after 1-2 weeks.

26. Ten Pathological Phenomena:

• Hypothermia, respiratory distress, patent ductus arteriosus, infection, metabolic, input-output, gastrointestinal disease, neurological complications, retinopathy, late complications.

Note: This information is for reference only, you should consult with a specialist doctor for appropriate advice and treatment.