Skip to main content

Specific Risks for the Preterm Infant

  • Living reference work entry
  • First Online:
Pediatric Surgery

Abstract

Preterm birth – birth before 37 completed weeks of gestation – occurs in approximately 5–18% of births worldwide. Babies born preterm have increased mortality and are at a greater risk of morbidity and long-term adverse outcomes than infants born at term. Though the rate of preterm birth is relatively lower in developed countries than in developing countries, prematurity is the leading cause of neonatal mortality in both developing and developed countries. Infants born prematurely have less time to develop in utero, and their organs and body systems are still undergoing physiological development process at the time of birth. This immaturity of body organs combined with low birth weight puts preterm infants at risk of developing various short- and long-term complications. Babies born extremely preterm (<28 weeks of gestation) are at highest risk of developing medical problems that are specific and unique to the preterm population, and they should be managed differently to term infants during hospitalization in the neonatal period.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

References

  • Adams-Chapman I, Hansen NI, Stoll BJ, et al. NICHD Research Network. Neurodevelopmental outcome of ELBW infants with posthemorrhagic hydrocephalus requiring shunt insertion. Pediatrics. 2008; 121:e1167–77.

    Google Scholar 

  • Aziz A, Ohlsson A. Surfactant for pulmonary haemorrhage in neonates. Cochrane Database Syst Rev. 2012;7:CD005254.

    Google Scholar 

  • Bhutta AT, Cleves MA, Casey PH, Cradock MM, Anand KJ. Cognitive and behavioural outcomes of school aged children who were born preterm: a meta-analysis. JAMA. 2002;288:728–37.

    Article  PubMed  Google Scholar 

  • Bulkowstein S, Ben-Shimol S, Givon-Lavi N, Melamed R, Shany E, Greenberg D. Comparison of early onset sepsis and community-acquired late onset sepsis in infants less than 3 months of age. BMC Pediatr. 2016;16:82.

    Article  PubMed  PubMed Central  Google Scholar 

  • Chernick V. Continuous distending pressure in hyaline membrane disease: of devices, disadvantages, and a daring study. Pediatrics. 1973;52(1):114–5.

    CAS  PubMed  Google Scholar 

  • Costeloe KL, Hennessy EM, Haider S, Stacey F, Marlow N, Draper ES. Short term outcomes after extreme preterm birth in England: comparison of two birth cohorts in 1995 and 2006 (the EPICure studies). BMJ. 2012;345:e7976.

    Article  PubMed  PubMed Central  Google Scholar 

  • Cox JMR, Boehm JJ, Millare EA. Individual nasal masks and intranasal tubes: a non-invasive neonatal technique for the delivery of continuous positive airway pressure (CPAP). Anaesthesia. 1974;29:597–600.

    Article  CAS  PubMed  Google Scholar 

  • Dempsey EM, Barrington KJ. Diagnostic criteria and therapeutic interventions for the hypotensive very low birth weight infant. J Perinatol. 2006;26:677–81.

    Article  CAS  PubMed  Google Scholar 

  • Dempsey EM, Barrington KJ. Treating hypotension in the preterm infant: when and with what: a critical and systematic review. J Perinatol. 2007;27:469–78.

    Article  CAS  PubMed  Google Scholar 

  • Dyet LE, Kennea N, Counsell SJ, Maalouf EF, Ajayi-Obe M, Duggan PJ, Harrison M, Allsop JM, Hajnal J, Herlihy AH, Edwards B, Laroche S, Cowan FM, Rutherford MA, Edwards AD. Natural history of brain lesions in extremely preterm infants studied with serial magnetic resonance imaging from birth and neurodevelopmental assessment. Pediatrics. 2006;118:536–48.

    Article  PubMed  Google Scholar 

  • Enhorring G, Shennan A, Possmayer F, Dunn M, Chen CP, Milligan J. Prevention of neonatal respiratory distress syndrome by tracheal instillation of surfactant: a randomized clinical trial. Pediatrics. 1985;76(2):145–53.

    Google Scholar 

  • Fitzgibbons SC, Ching Y, Yu D, et al. Mortality of necrotizing enterocolitis expressed by birth weight categories. J Pediatr Surg. 2009;44:1072–5.

    Article  PubMed  Google Scholar 

  • Fujiwara T, Maeta H, Chida S, Morita T, Watabe Y, Abe T. Artificial surfactant therapy in hyaline-membrane disease. Lancet. 1980;1:55–9.

    Article  CAS  PubMed  Google Scholar 

  • Gamsu HR, Mullinger BM, Donnai P, Dash CH. Antenatal administration of betamethasone to prevent respiratory distress syndrome in preterm infants: report of a UK multicentre trial. Br J Obstet Gynaecol. 1989;96:401–10.

    Article  CAS  PubMed  Google Scholar 

  • Hallman M, Merritt TA, Jarvenpaa A-L, et al. Exogenous human surfactant for treatment of severe respiratory distress syndrome: a randomized prospective clinical trial. J Pediatr. 1985;106:963–9.

    Article  CAS  PubMed  Google Scholar 

  • Hintz SR, Kendrick DE, Stoll BJ, Vohr BR, Fanaroff AA, Donovan EF, Poole WK, Blakely ML, Wright L, Higgins R, for the NICHD Neonatal Research Network. Neurodevelopmental and growth outcomes of extremely low birth weight infants after necrotising enterocolitis. Pediatrics. 2005;115:696–703.

    Article  PubMed  Google Scholar 

  • Horbar JD, Carpenter JH, Badger GJ, Kenny MJ, Soll RF, Morrow KA, Buzas JS. Mortality and neonatal morbidity among infants 501–1500 grams from 2000 to 2009. Pediatrics. 2012;129:1019–26.

    Article  PubMed  Google Scholar 

  • Jobe AH. Pulmonary surfactant therapy. N Engl J Med. 1993;328:861–8.

    Article  CAS  PubMed  Google Scholar 

  • Kattwinkel J, Fleming D, Cha CC, Fanaroff AA, Klaus MH. A device for administration of continuous positive airway pressure by the nasal route. Pediatrics. 1973;52:131–4.

    CAS  PubMed  Google Scholar 

  • Kumar VH, Clive J, Rosenkrantz TS, Bourque MD, Hussain N. Inguinal hernia in preterm infants (≤ 32 weeks gestation). Pediatr Surg Int. 2002;18:147–52.

    Article  PubMed  Google Scholar 

  • Liggins GC, Howie RN. A controlled trial of antepartum glucocorticoid treatment for prevention of the respiratory distress syndrome in premature infants. Pediatrics. 1972;50(4):515–25.

    CAS  PubMed  Google Scholar 

  • Lissauer T, Fanaroff AA. Neonatology at a glance. 2nd ed. Chichester/Malden: Wiley-Blackwell Press; 2011. Hoboken NJ, USA.

    Google Scholar 

  • Marlow N, Wolke D, Bracewell MA, Samara M. Neurologic and developmental disability at six years of age after extremely preterm birth. N Engl J Med. 2005;352:9–19.

    Article  CAS  PubMed  Google Scholar 

  • Ment LR, Ehrenkranz RA, Duncan CC, Scott DT, Taylor KJW, Katz KH, Schneider KC, Makuch RW, Oh W, Vohr B, Philip AGS, Allan W. Low-dose indomethacin and prevention of intraventricular hemorrhage: a multicenter randomised controlled trial. Pediatrics. 1994;93(4):543–50.

    CAS  PubMed  Google Scholar 

  • Moore T, Hennessy EM, Myles J, Johnson SJ, Draper ES, Costeloe KL, Marlow N. Neurological and developmental outcome in extremely preterm children born in England in 1995 and 2006: the EPICure studies. BMJ. 2012;345:e7961.

    Article  PubMed  PubMed Central  Google Scholar 

  • Morley CJ, Davis PG, Doyle LW, et al. Nasal CPAP or intubation at birth for very preterm infants. N Engl J Med. 2008;358:700–8.

    Article  CAS  PubMed  Google Scholar 

  • Moss RL, Dimmitt RA, Barnhart DC, et al. Laparotomy versus peritoneal drainage for necrotizing enterocolitis and perforation. N Engl J Med. 2006;354:2225–34.

    Article  CAS  PubMed  Google Scholar 

  • National Institute for Health and Clinical Excellence. Neonatal jaundice. Clinical Guideline 98. 2016. www.nice.org.uk/CG98

  • Neu J, Walker WA. Necrotizing enterocolitis. N Engl J Med. 2011;364:255–64.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Ohlsson A, Walia R, Shah SS. Ibuprofen for the treatment of patient ductus arteriosus in preterm and/or low birth weight infants. Cochrane Database Syst Rev. 2013;4:CD003481.

    Google Scholar 

  • Pammi M, Weisman LE. Late-onset sepsis in preterm infants: update on strategies for therapy and prevention. Expert Rev Anti-Infect Ther. 2015;13(4):487–504.

    CAS  PubMed  Google Scholar 

  • Papageorglou AN, Desgranges MF, Masson M, Colle E, Shatz R, Gelfand MN. The antenatal use of betamethasone in the prevention of respiratory distress syndrome: a controlled double-blind study. Pediatrics. 1979;63:73–9.

    Google Scholar 

  • Papile LA, Burstein J, Burstein R, Koffler H. Incidence and evolution of subependymal and intraventricular haemorrhage: a study of infants with birthweights less than 1500 gm. J Pediatr. 1978;92:529–34.

    Article  CAS  PubMed  Google Scholar 

  • Papworth S, Cartlidge PHT. Pulmonary haemorrhage. Curr Paediatr. 2001;11:167–71.

    Article  Google Scholar 

  • Rees CM, Hall NJ, Eaton S, Pierro A. Surgical strategies for necrotising enterocolitis: a survey of practice in the United Kingdom. Arch Dis Child Fetal Neonatal Ed. 2005;90:F152–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Rees CM, Pierro A, Eaton S. Neurodevelopmental outcomes of neonates with medically and surgically treated necrotising enterocolitis. Arch Dis Child Fetal Neonatal Ed. 2007;92:F193–8.

    Article  PubMed  Google Scholar 

  • Rees CM, Eaton S, Pierro A. National prospective surveillance study of necrotizing enterocolitis in neonatal intensive care units. J Pediatr Surg. 2010;45(7):1391–7.

    Article  PubMed  Google Scholar 

  • Rennie JM, et al. Rennie and Roberton’s textbook of neonatology. 5th ed. Edinburgh: Churchill Livingstone Elsevier; 2012. London, UK.

    Google Scholar 

  • Rhodes PG, Hall RT. Continuous positive airway pressure delivered by face mask in infants with the idiopathic respiratory distress syndrome: a controlled study. Pediatrics. 1973;52:1–5.

    CAS  PubMed  Google Scholar 

  • Schmidt B, Davis P, Moddemann D, Ohlsson A, Roberts R, Saigal S, Solimano A, Vincer M, Wright LL, for the Trial of Indomethacin Prophylaxis in Preterms Investigators. Long-term effects of indomethacin prophylaxis in extremely-low-birth-weight infants. N Engl J Med. 2001;344:1966–72.

    Article  CAS  PubMed  Google Scholar 

  • Schmidt B, Roberts R, Davis P, Doyle LW, Barrington KJ, Ohlsson A, Solimano A, Tin W, for the Caffeine for Apnea of Prematurity Trial Group. Caffeine therapy for apnea of prematurity. N Engl J Med. 2006;354:2112–20.

    Article  CAS  PubMed  Google Scholar 

  • Shapiro DL, Notter RH, Morin III FC, et al. Double-blind, randomised trial of a calf lung surfactant extract administered at birth to very premature infants for prevention of RDS. Pediatrics. 1985;76:593–9.

    CAS  PubMed  Google Scholar 

  • Soll R, Ozek E. Multiple versus single doses of exogenous surfactant for the prevention or treatment of neonatal respiratory distress syndrome. Cochrane Database Syst Rev. 2009;1:CD000141.

    Google Scholar 

  • Stoll BJ, Hansen NI, Bell EF, et al, Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Neonatal outcomes of extremely preterm infants from the NICHD neonatal research network. Pediatrics. 2010; 126:443–56.

    Google Scholar 

  • SUPPORT Study Group. Early CPAP versus surfactant in extremely preterm infants. N Engl J Med. 2010;362:1970–9.

    Article  Google Scholar 

  • Van Overmeire B, Follens I, Hartmann S, Cretan WL, Van Acker KJ. Treatment of patient ductus arteriosus with ibuprofen. Arch Dis Child Fetal Neonatal Ed. 1997;76:179–84.

    Article  Google Scholar 

  • Wiswell TE. Expanded uses of surfactant therapy. Clin Perinatol. 2001;28:695–711.

    Article  CAS  PubMed  Google Scholar 

  • World Health Organization. Preterm birth. Fact sheet N° 363. 2015. http://www.who.int/mediacentre/factsheets/fs363/en/

  • Yee WH, Soraisham AS, Shah VS, Aziz K, Yoon W, Lee SK, the Canadian Neonatal Network. Incidence and timing of presentation of necrotizing enterocolitis in preterm infants. Pediatrics. 2012;129:e298–304.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Colm P.F. O’Donnell .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer-Verlag GmbH Germany

About this entry

Cite this entry

Kieran, E.A., O’Donnell, C. (2016). Specific Risks for the Preterm Infant. In: Puri, P. (eds) Pediatric Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-38482-0_9-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-38482-0_9-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-38482-0

  • Online ISBN: 978-3-642-38482-0

  • eBook Packages: Springer Reference MedicineReference Module Medicine

Publish with us

Policies and ethics