CLINICAL PEARL Complications Associated with Premature Birth

Parents of preterm infants and those at risk for preterm delivery face two major unknowns: Will this child survive? And, if he or she does, will major long-term disabilities ensue? Caregivers attempt to use the limited information available to guide parents as they make complicated decisions regarding the initiation, escalation, or withdrawal of intensive care for their children. An understanding of the early complications and long-term morbidities associated with premature birth provides the foundation for this guidance. Complications in the Early Newborn Period Respiratory distress syndrome. The earliest recognized complication associated with premature birth is respiratory distress syndrome (RDS). RDS is the result of insufficient surfactant production by the immature lung, leading to decreased lung compliance and inadequate gas exchange. Both the incidence and severity of this disorder are inversely related to the infant’s gestational age. Within hours of delivery, affected infants develop symptoms of respiratory distress that include tachypnea, grunting, retractions, hypoxemia, hypercarbia, and acidosis