Академический Документы
Профессиональный Документы
Культура Документы
on the Newborn
Julniar M. Tasli
Herman Bermawi
Indrayady
Background
• Improvements in obstetric care can directly influence
neonatal survival
• Spacing of pregnancy
• Adequacy of prenatal care including immunizations
(4 visits or more)
• Avoiding pregnancy at extremes of maternal age
• Avoidance of extremes of maternal pre-pregnancy
weight (under-weight and morbid obesity)
• Appropriate weight gain and physical activity
• Balanced nutrition (micronutrient intake;
iron, zinc, folic acid, iodine, calcium)
• Avoidance of environmental exposures
(nicotine, other drugs, medications,
pesticides)
• Mental health including stress and
depression
Lack of compliance can be directly and
indirectly associated with :
• Prematurity and low birth weight and
complications associated with these
important contributors to infant mortality
and morbidity
• Higher incidence of specific neonatal
complications e.g. congenital anomalies
(neural tube defects) and in-utero growth
retardation
Prenatal care and its role:
Viral Infections:
• Cytomegalovirus
– Transmitted trans-placentally, breast milk
– Associated with IUGR, hepatosplenomegaly,
microcephaly, retinopathy, and hydrops
• Varicella Zoster
– Transmitted transplacentally (<20 weeks, and
also by contact after birth)
– Congenital varicella; Microcephaly, retinitis, scars
on the skin
– Neonatal varicella
• HIV
– Transmitted transplacentally, during labor and in
breast milk
– Neonatal HIV/AIDS mostly asymptomatic in the
immediate neonatal period although some
manifest IUGR
• Hepatitis B
– Transmitted mainly as an ascending infection,
and through breast feeding, rarely
transplacentally.
– Associated with post-natal chronic hepatitis,
cirrhosis and hepatocellular carcinoma.
Non-viral infections:
• Treponema pallidum (syphilis)
– Transmitted transplacentally, anytime during
pregnancy (worst effects with early infection)
– Associated with fetal loss and still birth, and
congenital syphilis (skin and mucous membrane
lesions, hepato-splenomegaly, anemia and
thrombocytopenia, bone lesions)
• Neisseria Gonorrhoea
– Ascending infection intrapartum
– Ophthalmia neonatorum (early)
• Toxoplasma gondii
– Transplacentally transmitted with the worst
effects in early transmission
– Associates with Hydrocephalus/microcephaly,
brain calcifications, hepatosplenomegaly,
retintis/blindness hearing loss and mental
retardation.
C. Thyroid Diseases
Hypothyroidism