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Complications After Preterm Birth: An Overview for Emergency Physicians
Praveen Kumar, MBBS, DCH, MD, ⁎ Gautham Suresh, MD, DM, MS†
Nearly 65000 very low-birth-weight infants are born each year in the United States. Survival of these very premature infants has significantly increased over time with improvements in obstetric and neonatal care such as use of antenatal steroid and postnatal surfactant therapy, improved resuscitation and ventilation strategies, and use of early enhanced parenteral nutrition. However, a significant proportion of these infants develop either one or more complications of prematurity and may require ongoing care after their discharge. It is estimated that nearly 25% very low-birth-weight infants and as many as 80% extremely low-birth-weight infants have at least one readmission to the hospital. Many of these infants present to the emergency department with an illness that may be related to the complications of prematurity, and a basic understanding of these morbidities will allow emergency department physicians to provide optimal care to these infants. This article provides a brief summary of common morbidities seen in these high-risk infants. Clin Ped Emerg Med 9:191-199 C 2008 Elsevier Inc. All rights reserved. KEYWORDS preterm, very low birth weight, extremely low birth weight, intraventricular hemorrhage, periventricular leukomalacia, apnea of prematurity, bronchopulmonary dysplasia, necrotizing enterocolitis, retinopathy of prematurity

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early 13% of all babies are born preterm in the United States each year, and the proportion of live births with birth weight not exceeding 1500 g (very low-birthweight [VLBW] infants) has increased gradually from 1.17% to 1.48% over the last 3 decades [1]. This would suggest that, with approximately 4.3 million live births each year, nearly 65000 VLBW infants are born each year in the United States. Over this same period, there has been a significant reduction in mortality rates for this group