Mosby items and derived items © 2005, 2001 by Mosby, Inc.

Perspectives of Pediatric Nursing

ERNIE B. GUEVARRA, M.D.

Mosby items and derived items © 2005, 2001 by Mosby, Inc.

DEFINITION OF TERMS

Live Birth: the complete expulsion or extraction from the mother of the product of conception, irrespective of the duration of pregnancy, which after expulsion or extraction breaths or shows any evidence of life.

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DEFINITION OF TERMS

Fetal Death: death prior to the complete expulsion or extraction from the mother of the product of human conception, fetus or embryo, irrespective of the duration of pregnancy

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FETAL DEATH

Early Fetal Death: death prior to the complete expulsion or extraction from the mother of fetus or embryo weighing 500 gm or less (about 20 weeks gestation)

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FETAL DEATH

Late Fetal Death (Still Birth): death prior to the complete expulsion or extraction from the mother in which fetal weight is greater than 500 gm or if the weight is unknown, the duration of pregnancy exceeds 20 weeks of gestation and a body length of > 25 cm (crown-heel)

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Infant Mortality

• Definition: Number of deaths per 1000 live births during first year of life (364 days, 23 hours, 59 minutes from the moment of birth)

– Neonatal period: <28 days of life

– Postnatal period: 28 days to 1 year

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NEONATAL DEATHS

– Early Neonatal death: death of a live born neonate during the 1st 7 days from the moment of birth

– Late Neonatal Death: death of a liveborn neonate after seven completed days (168 hours) but before 28 days of life

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DEFINITION OF TERMS

Gestational Age: number of completed weeks that have elapsed between the first day of the last menstrual period and the date of delivery

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DEFINITION OF TERMS

Preterm Neonate: any neonate whose GA calculated from the 1st day of LMP, is < 37 completed weeks or < 259 completed days, irrespective of weight at birth

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DEFINITION OF TERMS

• Term Neonate: any neonate whose GA calculated from the 1st day of LMP, is equal to or > than 37 wks and =/< 42 wks (259 to 294) days, irrespective of wt at birth

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DEFINITION OF TERMS

• Post term Neonate: any neonate whose GA calculated from the 1st day of LMP, is > 42 wks of gestation (=/> 259 days) irrespective of wt at birth)

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Birth Weight

• Major determinant of neonatal death in the Philippines.

• LBW: <2500 g

• VLBW: 1000-1500 g

• ELBW: <1000g

• Lower birth weight = Higher mortality

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Other Risk Factors for Infant Mortality

• Male gender

• Short or long gestation

• Birth order

• Maternal age (younger or older)

• Maternal education

• Black race

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Childhood Mortality

• Injuries are leading cause of death in age >1 year

– Motor vehicle crashes

– Drowning

– Burns

– Poisoning

– Firearms

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INFANT MORTALITY

Ten (10) Leading Causes Number & Rate/1000 Livebirths & Percentage Distribution

Philippines, 2004

Cause Percent

1. Bacterial sepsis of newborn 15.1

2. Respiratory distress of newborn 11.1

3. Pneumonia 8.6

4. Disorders related to short gestation and low birth weight, not elsewhere classified 7.8

5. Congenital Pneumonia 6.7

6. Congenital malformation of the heart 6.4

7. Neonatal aspiration syndrome 5.6

8. Other congenital malformation 4.8

9. Intrauterine hypoxia and birth asphyxia 4.6

10. Diarrhea and gastro-enterities of presumed

infectious origin 4.1

Source:  The 2004 Philippine Health Statistics* percent share from total infant deaths, all causes, Philippines  Last Update: February 12, 2008

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Childhood Morbidity

• May denote acute illness, chronic disease, or disability

• Difficult to define and measure

• The “new morbidity”

– Social, behavioral, educational problems that may alter health