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Prematurity

Prematurity. PSY 417 Schuetze. Prematurity. Before 37 th week of gestation 7-10% of all live births Extreme prematurity: Before 28 th week gestation http://www.youtube.com/watch?v=JsFT1xEIHzM&NR=1&feature=fvwp. Etiology. Maternal age Poor nutrition Inadequate prenatal care

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Prematurity

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  1. Prematurity PSY 417 Schuetze

  2. Prematurity • Before 37th week of gestation • 7-10% of all live births • Extreme prematurity: Before 28th week gestation • http://www.youtube.com/watch?v=JsFT1xEIHzM&NR=1&feature=fvwp

  3. Etiology • Maternal age • Poor nutrition • Inadequate prenatal care • Substance use • Toxemia • Previous pregnancies • Weak cervical muscles: incompetent cervix • Multiple births • Maternal infections • Congenital malformations

  4. Physical Appearance

  5. Lanugo

  6. Skin Color

  7. Complications • Respiratory Distress Syndrome (RDS) • surfactant • Bronchopulminary Dysplasia • Intracerebral Insults • SIDS • Retinopathy of Prematurity

  8. RDS

  9. Prognosis - survival • < 800 grams • 1977 – 20% survival rate • 1990 – 40% survival rate • > 800 grams – 90% survival • 28 weeks – 80% survival

  10. Prognosis - developmental • http://www.youtube.com/watch?v=Ncxlp5e-5oU&feature=PlayList&p=96630BC69007A739&index=0&playnext=1 • More than 50% born at 25 weeks have learning difficulties or problems with eyesight and hearing • 12-32% - CP or MR • 5-25% - visual impairments • 5-12% - hearing impairments • 20-30% ADHD • 50% - learning disorders

  11. Behavioral Characteristics • Sleep • Increased total sleep • Wake more frequently • 23-27 weeks • States are diffuse • Jerky movements, tremors • Irregular RR and HR • Infrequent crying • 30-37 weeks • Gradual development of quiet sleep • More regular respiration

  12. Behavioral Characteristics • Feeding • Reflexes • 28 weeks: Can elicit slow rooting, sucking, swallowing reflexes • 34 weeks: Become coordinated

  13. Brain Development • The more premature, the slower it develops “nooks and crannies” • -surface area for neural connections • 30% less gray matter (thinking) • 40% less white matter (fiber connections)

  14. Brain Development • http://www.youtube.com/watch?v=c-dmwKJS-fs

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