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4.classification of Newborn

This document discusses different ways to classify newborns. It describes classifications based on size (birth weight), gestational age, mortality risk, and postnatal age. Key classifications include preterm/full term, small for gestational age, appropriate for gestational age, and classifications related to mortality such as live births, stillbirths, and neonatal/perinatal deaths. The document also discusses problems that may affect low birth weight or preterm infants.

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Saeda Ahmed
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0% found this document useful (0 votes)
139 views33 pages

4.classification of Newborn

This document discusses different ways to classify newborns. It describes classifications based on size (birth weight), gestational age, mortality risk, and postnatal age. Key classifications include preterm/full term, small for gestational age, appropriate for gestational age, and classifications related to mortality such as live births, stillbirths, and neonatal/perinatal deaths. The document also discusses problems that may affect low birth weight or preterm infants.

Uploaded by

Saeda Ahmed
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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Classification of newborn

Dr.Abdikarim Awale
Classification of newborn

1. Classification according to size.


2. Classification according to gestational
age.
3. Classification according to mortality.
4. Classification according to post natal
Age.
Classification according to size

1. Low birth weight (LBW): <2500gm


2. Very low birth weight (VLBW):
<1500gm
3. Extremely Low birth weight ELBW:
<1000g.
Classification according to size

4. Appropriate for gestational


age:
An infant whose weight at birth
lies between 10-90th centiles of
the expected for his gestational
age.
Classification according to size

5. Small for date (SFD) infant or Small


for gestational age (SGA) infant:
-SGA <10th centile.
6. Large for gestational age infant:
-LGA>90th centile.
LGA
• Associated with maternal diabetes
• High fetal insulin even in absence of maternal
diabetes
• Morbidity
– Birth trauma
– Hypoglycemia
– Polycythemia
– Congenital heart disease
– High cesarean delivery
Small for gestational age (SGA) infant:

SGA / IUGR
• SGA is based on physical evaluation of an
infant at birth, usually by a pediatrician or
neonatologist.
• IUGR is a prenatal diagnosis to describe
a fetus who fails to reach in utero growth
potential, often diagnosed by the
obstetrician.
Causes of SGA/IUGR

 Poor nutritional  post maturity


status of mother  Chronic malaria
 Hypertension  chronic illness
 anemia  Tobacco use
 Multiple
pregnancy
Intrauterine growth chart
4400

4000 90th percentile


LARGE FOR DATE
3600
Birth weight (grams)

3200
APPROPRIATE FOR DATE
2800

2400
10th percentile
2000

1600 SMALL FOR DATE

1200

800 PRETERM TERM POST-TERM


400
31 33 35 37 39 42 44 45
Gestation (weeks)
LBW: Identification of types

SGA
• Physical characteristics
– Emaciated look.
– Loose folds of skin.
– Lack of subcutaneous tissue.
– Head bigger than chest by >3cm.
LBW Identification: SGA

2.1 Kg - IUGR 3.2 Kg - AFD


There are basically two different types of IUGR:

1. Symmetric or primary 2. Asymmetric or


IUGR is characterized by secondary IUGR is
all internal organs being
characterized by the
reduced in size.
Symmetric IUGR head and brain being
accounts for 20% to 25% normal in size, but
of all cases of IUGR. the abdomen is
• Causes: chromosomal smaller.
abnormalities , genetic, • Causes:
malformation, teratogenic,
infectious (torch infections),
-preeclampsia
or severe chronic maternal -Postdate
hypertensive etiologies.
Calculate Ponderal index in SGA
babies.
•  P.I. = Weight in gram / (length in
cm)3 x 100
•  < 2 = Asymmetrical SGA
•  > 2 = Symmetrical SGA
•  > 2.5= TERM and AGA
LBW (SGA) : Problems

 Birth asphyxia
 Meconium aspiration syndrome
 Hypothermia
 Hypoglycemia
 Infections
 Polycythemia
LBW: Issues in delivery

 Transfer mother to a well-equipped


centre before delivery
 Skilled person needed for effective
resuscitation
 Prevention of hypothermia – top most
priority
LBW: Indications for hospitalization

• Birth weight <1500 g


• Gestation <34 wks
• Unable to feed*
• Sick neonate*

* Irrespective of birth weight and gestation


Classification according to GA

1. Premature infant (pre-term).


less than 37 weeks gestation.
2. Full term infant- completed 37
weeks gestation till 42 week .
3. Post mature infant (post-
term).- More than 42 weeks
Classification according to GA

• SUB-CATEGORIES OF
PREMATURE INFANTS:
I. Extremely Preterm (<28 Weeks)
II. Very Preterm (28 To <32 Weeks)
III. Moderate to late preterm (32 to 36
weeks and 6 days).
Classification according to GA

Moderate to late preterm is further


devided into:
1. ModeratePreterm Infants : those born
between 32and 33 weeks and 6 days
2. Late Preterm Infants : asthose born
between 34and 36 weeks and 6 days
Etiology of prematurity

• Low maternal
weight • acute systemic
• Teenage / multiple disease
pregnancy • Induced premature
• Previous preterm delivery
baby • Majority unknown
• cervical
incompetence
• Antepartum
hemorrhage
Prematurity Identification

Prematurity
• Date of LMP
• Physical features
– Breast nodule
– Genitalia
– Sole creases
– Ear cartilage / recoil
Identification: Preterm LBW

Breast nodule

Preterm Term

Preterm Term
Identification: Preterm LBW
Male genitalia
Preterm
Preterm Term
Term
Identification: Preterm LBW
Female genitalia
Preterm Term
Identification: Preterm LBW
Sole creases
Preterm Term
Identification: Preterm LBW
Ear Cartilage

Preterm Term
Preterm : Problems

 Birth asphyxia  Retinopathy of


prematurity
 Hypothermia
 Apnea
 Feeding difficulties
 Infections
 Intraventricular
hemorrhage
 Hyperbilirubinemia
 Hypoglycemia
 Respiratory distress
syndrome  Metabolic acidosis
 Necrotizing enterocolitis
Preterm : Problems
• Hypothermia classification
• Hypothermia has been defined by WHO
as body temperature below the normal
range (36.5°C – 37.5°C) and has been
sub-classified into three grades:
1. mild (36.0°C – 36 .5°C)
2. moderate (32.0°C – 35.9°C)
3. severe (<32.0°C)
Classification according to mortality

1. Live birth
2. Stillborn/Fetal death
3. Neonatal death
4. Perinatal mortality
5. Post natal death.
CONT…
• Live birth: is the complete expulsion or
extraction from its mother of a product of
conception, irrespective of the duration of
the pregnancy, which, after such
separation, breathes or shows any other
evidence of life, such as beating of the
heart, pulsation of the umbilical cord, or
definite movement of voluntary muscles is
considered live born.
CONT…
• Stillborn/Fetal death: refers to a dead
born fetus . Intrauterine death occurs either
before onset of labour (Antepartum death) or
during labour (intrapartum death).
• Neonatal death: is defined as
a death during the first 28 days of life.
• Perinatal mortality: Fetal deaths after 24
completed weeks of gestation
and death before 7 completed days.
CONT…
• POSTNEONATAL MORTALITY RATE :
is the number of resident newborns
dying between 29 and 364 days of life.
Or as the number of infant deaths occurring
between 29 days and 1 year of life.
Classification according to post
natal Age

1.Early neonatal period:


– from the birth until 6 days after birth.
2.Late neonatal period:
- from 7 days until 28 days after birth.

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