Neonatal risks and NICU problems
Common early threats include respiratory failure, infection, hypoglycemia, jaundice, temperature instability, and complications of prematurity.
RDS / hyaline membrane disease
- Surfactant deficiency in immature lungs → atelectasis and impaired gas exchange.
- Prevention: antenatal corticosteroids when preterm birth is likely.[6]
- Treatment: CPAP, gentle ventilation, and timely surfactant; European consensus guidance summarizes evidence-based pathways.[7]
- Severe cases risk bronchopulmonary dysplasia and neurodevelopmental morbidity.
- Intracranial haemorrhage (ICH): bleeding within the brain, most common in premature infants; may lead to seizures, hydrocephalus, or long-term neurodevelopmental impairment.
Oxygen and ROP
- ROP risk rises with prematurity and oxygen exposure.
- NICUs commonly use oxygen saturation target ranges (often around 90–95% in ELBW infants) to reduce severe ROP while avoiding hypoxemia-related harm.[13]
- Screening is protocol-driven; treatment includes laser and/or anti-VEGF in selected cases.
Sepsis
- Risk factors: prematurity, prolonged rupture of membranes, maternal infection, invasive lines/ventilation.
- Presentation: temperature instability, feeding intolerance, apnea, lethargy, respiratory deterioration.
- Treatment: cultures + prompt empiric antibiotics and supportive care; tailor once results return.
Hypoglycemia
- Risk: infant of diabetic mother, late-preterm, SGA/LGA, stress/asphyxia.
- Management: early feeding, monitoring, and IV dextrose when symptomatic or persistently low.
- Severe/prolonged hypoglycemia can cause brain injury; protocols balance prevention with avoiding unnecessary separation.
Jaundice
- Physiologic jaundice is common; risk increases with prematurity, bruising, hemolysis, and feeding difficulties.
- Rarely, very high bilirubin causes kernicterus; prevention relies on screening and timely phototherapy/exchange transfusion per local nomograms.
NEC
- Primarily a disease of prematurity with inflammation, ischemia, and dysbiosis.
- Human milk feeding is associated with reduced NEC risk in preterm infants.[14]
- Some NICUs use probiotics for very-low-birthweight infants; practices vary by region/product regulation.
- Treatment ranges from medical management (bowel rest/antibiotics) to surgery for perforation/necrosis; outcomes vary.