To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure firstname.lastname@example.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
After about 32 weeks' gestation, the neurodevelopmental outcome of premature infants appears to be independent of gestation. However, before 32 weeks there is an almost linear relationship between IQ measured later in life and the gestation at which the baby was born. This was shown by a study of the neurodevelopmental outcome of preterm infants by Wolke and colleagues (2001). The authors assessed IQ at 4 years and 8 months. They considered the relationship between medical and social risk factors using data from the Bavarian Longitudinal Study, which had investigated the cognitive and behavioral development of children considered to be vulnerable because of neonatal adversity. Their conclusion was that cognitive and school outcome for infants born before 32 weeks' gestation was better predicted by neonatal risk (by which they meant prematurity and low birthweight) than social factors. The reverse was true for more mature infants. These data fit well with more recent information from very immature infants born before 26 weeks. A UK cohort of very premature babies born in 2000 were included in the Epicure study (see below), which looked at their outcome when they were 6 years old (Marlow et al.,2005). The data from Bavaria and the UK have been combined in Fig. 19.1.
Thus, if birth occurs before about 32 weeks, the more premature an individual is, the greater the degree of disability.
The importance of a planned and coordinated approach to the initial resuscitation, stabilisation and subsequent management of babies born between 27 and 28 completed weeks' gestation was emphasised in the Confidential Enquiries of Stillbirths and Deaths in Infancy (CESDI) Project 27/28 Enquiry (Mackintosh 2003). This chapter covers many of the aspects of care that the report highlighted as contributing to optimising the care of the premature infant. More than 90% of the babies studied for the CESDI report required resuscitation. Having a resuscitation system based on the needs of infants is the recommended approach. The resuscitation guidelines used by the neonatal life support course have been formalised for the term neonate based on combined evidence from the limited pool of resuscitation trials, consensus views on best practice and experimental animal models (Kattwinkel et al. 1999; Niermeyer et al. 2000). The basic approach to resuscitating a preterm neonate is similar to that of the term neonate with emphasis on maintaining body heat and possible earlier progression to advanced manoeuvres to stabilise the airway and administer exogenous surfactant.
Communication forms a cornerstone of the management of imminent preterm deliveries. Liaison between the delivery suite and the Neonatal Intensive Care Unit (NICU) is thus essential to ensure that potential problems are anticipated and that appropriate cot spaces are available.
Email your librarian or administrator to recommend adding this to your organisation's collection.