Maternity Lab: High-Risk Newborn

≤ 37 weeks (Ballard score)

What gestational age defines a premature newborn?

It increases with gestational age

How does muscle tone change with gestational age?

Hypotonic and extended

What posture is seen in very preterm infants?

It is decreased

What happens to subcutaneous fat in preterm infants?

20–28 weeks gestation

When is lanugo present?

Around 28 weeks

When does lanugo begin to disappear?

28–30 weeks

When do plantar creases appear?

Spread toward heel with maturity

How do plantar creases progress?

26–28 weeks

When do eyelids open?

overriding sutures

What is common with skull sutures in preemies?

Minimal, pinna folds easily

Describe ear cartilage in preterm infants.

undescended, in inguinal canal

Where are testes in premature males?

prominent clitoris, small labia

Female genitalia in preemies?

tremors and jitteriness

What neuromuscular signs may occur?

weak cry

Describe cry of premature infant.

diminished or absent

How are reflexes in preemies?

around 34 weeks

When are suck/swallow/breathe coordinated?

immature feeding reflexes

Why do preemies need feeding support?

Pause ≥20 sec or shorter with symptoms

What is apnea?

hypovolemia or immature regulation

What causes hypotension in preemies?

patent ductus arteriosus

Why is a murmur common?

low EPO + frequent labs

Why is anemia common?

Prevent cold stress

Why maintain neutral thermal environment (NTE)?

Thin skin, low fat

Why are preemies prone to heat loss?

Dry infant immediately

First step after birth?

Polyethylene wrap

What barrier prevents heat loss?