High Risk Infant
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| Define the term high risk infant. | Any newborn/young infant who has a high probability of manifesting in childhood a sensory, motor, cognitive, language, or social deficit, followed for up to one year in a high risk clinic. | |
| Name the two most significant infant risk factors. | Birth weight and prematurity. | |
| Describe low, very low, and extremely low birth weight. | LBW: 3.3-5.5 lbs, VLBW: 2.2-3.3 lbs, ELBW: >2.2 lbs. | |
| Describe small, appropriate, and large for gestational age. | Weight, length, and head SGA: <10th%, AGA: between 10th and 90th%, LGA: >90th% | |
| What may cause a child to be small for gestational age? | Intrauterine growth retardation (IUGR) – the fetus did not grow appropriately while in-utero. | |
| Name the causes of asphyxia. | Trauma, prolonged labor, compression of the umbilical cord. | |
| Define hypoxic-ischemic encephalopathy. | A lesion in the brain caused by asphyxia. | |
| Name the clinical signs of hypoxic-ischemic encephalopathy. | Stupor or coma, seizures, and alterations in tone, posture, reflexes, respiration, and autonomic function, HIE is the leading cause of severe, nonprogressive neurological deficits resulting from perinatal events. | |
| A parasagittal lesion associated with HIE predisposes a child to what type of CP? | Quadriplegic motor deficits and generally spastic CP. | |
| A selective neuronal necrosis (often in cerebellum) associated with HIE predisposes a child to what type of CP? | Ataxic cerebral palsy. | |
| Periventricular leukomalacia with damage around the ventricles associated with HIE predisposes a child to what type of CP? | Affects tracts to LE’s, spastic diplegic CP. | |
| Marmoratus of the basal ganglia associated with HIE predisposes a child to what type of CP? | Athetoid cerebral palsy. | |
| Describe the significance of intraventricular hemorrhage (IVH). | The severity of the IVH appears to be correlated to neurological outcome. | |
| What is the neurological outcome for a grade I & II IVH? | Good prognosis, minimal risk for developing neurological deficits. | |
| What is the neurological outcome for a grade III & IV IVH? | Higher risks of neurological deficits including hydrocephalus, CP, and MR. | |
| Describe a grade I IVH. | Localized hemorrhage. | |
| Describe a grade II IVH. | Blood has ruptured into the ventricles, no ventricular enlargement. | |
| Describe a grade III IVH. | Blood ruptured into ventricles, ventricular enlargement, blockage of CSF leading to hydrocephalus if untreated. | |
| Describe a grade IV IVH. | Bleeding and destruction of brain substance, usually white matter. |
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