Immature newborn

An immature (premature) newborn is a newborn born before the end of the 37th week of pregnancy (< 37+0 weeks+days of pregnancy). Degrees of prematurity:
 * slight immaturity: 32-36 weeks of pregnancy; ("late preterm": 34+0 to 36+6 weeks+days);
 * intermediate immaturity: 28-32 weeks of pregnancy;
 * severe immaturity: 26-28 weeks of pregnancy;
 * extreme immaturity: < 26 weeks of gestation.



Morphological manifestations of immaturity:
 * skin – thin, delicate, rose-red, thick lanugo;
 * thin and long limbs;
 * fine and sparse hair, absence of sebum;
 * ears slightly curved, soft;
 * the nipple is almost impalpable;
 * there are usually edemas on lower limbs;
 * testes not ascending, protruding clitoris;
 * faintly visible furrowing of the feet.

Maturity assessment

 * In neonatology, the assessment of gestational age according to the Ballard scoring system is most often used - it evaluates the system of somatic signs, developmental functional responses of the newborn, and by combining them with a certain probability we arrive at the determination of gestational age.
 * Less often, the Petrussa index is used to assess maturity:
 * maturity (g. t.) = 30 + number of index points according to Petrussa

Complications of immaturity

 * Thermolability, risk of perinatal asphyxia.
 * Respiratory system:
 * respiratory distress syndrome – treatment: respiratory support, surfactant
 * Apnea of immaturity - in 50-60%, main cause is immaturity of respiratory control center in trunk and immaturity of receptors, treatment: methylxanthines;
 * bronchopulmonary dysplasia,
 * SIDS.
 * Cardiovascular system:
 * hypotension – more often in severely premature babies, treatment: volume adjustment, dopamine, adrenaline.
 * persistence of an open duct - in 40-60% of low birth newborns with PH below 1500 g. Closure is inhibited by increased production of PGE2 and PGI1. We observe a systolic murmur over the base of the heart, a hyperactive precordium, increased vascular pulsation. Treatment: ibuprofen, indomethacin.
 * Metabolic deviations:
 * hypoglycemia (low glycogen stores), hyperglycemia (low tolerance of intravenous glucose intake),
 * hypocalcemia,
 * hyponatremia,
 * metabolic bone disease of immaturity.
 * Anemia of immaturity.
 * Hyperbilirubinemia from immaturity.
 * Poor food tolerance, failure to thrive, risk of necrotizing enterocolitis.
 * Intraventricular/intraparenchymal bleeding - in the smallest up to 30-40% risk (under 1000 g up to 60%); periventricular leukomalacia.
 * Retinopathy of prematurity – a disorder of the development of the vessels of the immature retina with the risk of irreversible damage to the retina. Hearing damage.
 * Cerebral palsy, epilepsy, ADHD, short stature.

Related articles

 * Characteristics of the newborn period •Treatment of the newborn after birth