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Neonatal Disorders

A neonatal disorder is any condition that is diagnosed within the first four weeks of a new-born’s life. Neonatal disorders can be present at birth or develop shortly after birth. If a neonatal disorder is not treated properly, it can result in developmental problems or even death for the new-born. The highest number of neonatal deaths in the world occurs in sub-Saharan Africa.

Symptoms

Neonatal disorders have the following symptoms:

  • Jaundice
  • Poor feeding
  • Sleepiness and low energy
  • Rapid or laboured breathing
  • Failure to thrive
  • Lack of physical growth

The list above represents just a handful of symptoms shared among many neonatal disorders. However, there are a vast number of neonatal disorders, and some have their own set of unique symptoms. For example, aspiration is a neonatal disorder that can be identified by the following symptoms: difficulty feeding, coughing, gagging, arching of the back, and bluish skin.

Causes

The various causes of neonatal disorders are described below:

  • Genetics

In some cases, a neonatal disorder is inherited from one or both parents. A neonatal disorder can also be caused by a spontaneous mutation or abnormality within the baby’s genes.

  • Maternal health

The health of the mother during her pregnancy is linked to the health of the new-born. Maternal malnutrition, infection, smoking, drug use, and alcohol consumption are examples of just a few health conditions and activities that can cause neonatal disorders in a new-born.

  • Pregnancy complications

A complication of pregnancy can lead to premature birth and/or problems with the new-born. For example, gestational diabetes is a complication of pregnancy that can lead to premature birth and the baby having hypoglycaemia.

  • Premature birth

A baby requires at least 37 weeks of pregnancy to develop and mature. Many problems occur when a baby is born prematurely. Examples of neonatal disorders caused by premature birth include anaemia, cerebral palsy, hypoglycaemia, hypotension, hypothermia, jaundice, patent ductus arteriosus, respiratory distress syndrome, bronchopulmonary dysplasia, and necrotizing enterocolitis.

  • Low birth weight

Babies born with a low birth weight can struggle to thrive. They often face the same neonatal disorders as babies who are born prematurely.

  • Labour and delivery complications

Labour and delivery complications include failure to progress, malposition of the baby (i.e., breach), and lack of oxygen during birth. These complications can lead to asphyxia, meconium aspiration, and seizures.

  • Viral or bacterial infections

A new-born can become infected before, during, or after birth. Examples of neonatal disorders that can be caused by viral or bacterial infection include pneumonia, sepsis, meningitis, jaundice, and seizures.

Reference Articles

Risk Factors

Below are the risk factors that increase the odds of a new-born having a neonatal disorder:

  • History of preterm birth

Women who have a history of giving birth prematurely are more likely to have a repeat experience. Premature births are one of the causes of many neonatal disorders.

  • Lack of prenatal care

Prenatal care is important for monitoring the health of the mother and baby during pregnancy. With prenatal care, pregnancy complications can be diagnosed and treated before harm befalls the baby.

  • Lack of quality care at birth

Many problems can arise during labour and delivery. It is important that one has the necessary support to prevent any trauma to the new-born.

  • Lack of postnatal care

The first month is a vulnerable time for a new-born. Postnatal care, or the care given to a baby after birth, is important for monitoring the health of the new-born.

Diagnosis

Sometimes, doctors can diagnose a problem with a baby before it is born. This is done by testing the mother’s blood and performing ultrasounds of the foetus during prenatal visits. Examples of neonatal disorders that can be diagnosed before birth include Rh incompatibility and various heart defects.

Most of the time, doctors will diagnose a neonatal disorder shortly after birth. A neonatal disorder can be recognized during any of the following steps:

  • Physical examination

A baby undergoes a routine physical examination immediately after birth and periodically thereafter. Doctors and nurses will collect information on the baby’s size, skin colour, breathing, pulse rate, reflexes, muscle tone, and alertness. A doctor will also listen to the baby’s heart and lungs with a stethoscope.

  • Cord blood test

A sample of blood is taken from the umbilical cord when a baby is born. The blood is then used to measure the following: bilirubin level, oxygen level, blood sugar level, blood type, platelet count, and complete blood count. A blood culture is also prepared to check for infection.

  • Screening test – A screening test is not routine for many South African hospitals but is strongly recommended. The new-born’s blood (taken from a heel-prick) is tested 24 to 72 hours after birth. This screening test will check the new-born’s blood for various diseases which include genetic, metabolic, and endocrine disorders.
  • Oxygen level testing

Pulse oximeters are used to monitor the new-born’s oxygen levels. Low oxygens levels can signify that the baby has problems with its heart or lungs.

  • Feeding observation – The doctor and nurses visit the mother and baby regularly to assess the feeding process. Feeding problems (i.e., refusing to eat, gagging, spitting up, or crying) can be an indicator of a larger issue.

If an issue is found during any of the steps listed above, additional tests may need to be administered. These additional tests can include blood tests, echocardiogram (a test that studies the heart), X-rays, or ultrasound.

Treatment

The treatment for neonatal disorders varies depending on the specific disorder in question. Treatment can include any of the following:

  • Light therapy (also known as phototherapy)
  • Blood transfusion
  • Breathing support
  • Intravenous medication
  • Gastrostomy tube
  • Surgery

Prevention

There are several activities that can help prevent neonatal disorders. These activities are described below:

  • Seek prenatal care. Prenatal care is important for diagnosing and treating any complications of pregnancy.
  • A mother should strive for a healthy, balanced diet during pregnancy. This includes taking a daily prenatal vitamin that provides iron, folic acid, and other nutrients necessary for proper foetal development.
  • Have obstetricians or other professionals at the labour and delivery. This mitigates the risk of birth trauma if any complications arise.

Not all neonatal disorders can be prevented. That is why postnatal care (care given after the baby is born) is so important. Postnatal care offers a wealth of services. Clinicians can check for neonatal disorders, ensure there are no feeding problems, provide immunizations (BCG, polio, and hepatitis B), give a vitamin K injection, and more.

 
 
 

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