{"id":4895,"date":"2019-07-16T12:36:12","date_gmt":"2019-07-16T12:36:12","guid":{"rendered":"https:\/\/courses.lumenlearning.com\/wm-lifespandevelopment\/?post_type=chapter&#038;p=4895"},"modified":"2024-04-29T23:15:06","modified_gmt":"2024-04-29T23:15:06","slug":"newborn-assessment-and-risks","status":"publish","type":"chapter","link":"https:\/\/courses.lumenlearning.com\/wm-lifespandevelopment\/chapter\/newborn-assessment-and-risks\/","title":{"raw":"Newborn Assessment and Risks","rendered":"Newborn Assessment and Risks"},"content":{"raw":"<div class=\"textbox learning-objectives\">\r\n<h3>Learning Outcomes<\/h3>\r\n<ul>\r\n \t<li>Examine risks and complications with newborns<\/li>\r\n<\/ul>\r\n<\/div>\r\n<h2>Complications of the Newborn<\/h2>\r\n<h3>Assessing the Neonate<\/h3>\r\nThere are several ways to assess the condition of the newborn.\u00a0The most widely used tool is the\u00a0Neonatal Behavioral Assessment Scale\u00a0(NBAS) developed by T. Berry\u00a0Brazelton.\u00a0This tool has been used around the world to help parents get to know their infants and to make comparisons of infants in different cultures (Brazelton\u00a0&amp; Nugent, 1995).\u00a0The baby's motor development, muscle\u00a0tone, and stress response are assessed.\r\n\r\nThe\u00a0Apgar test is conducted one minute and five minutes after birth. This is a very quick way to assess the newborn's overall condition. Five measures are assessed: the heart rate, respiration, muscle tone (quickly assessed by a skilled nurse when the baby is handed to them or by touching the baby's palm), reflex response (the Babinski reflex is tested), and color. A score of 0 to 2 is given on each feature examined. An Apgar of 5 or less is cause for concern.\u00a0The second Apgar should indicate improvement with a higher score.\r\n<div class=\"textbox examples\">\r\n<h3>Watch it<\/h3>\r\nWatch this video that explains how to calculate the Apgar score for a newborn.\r\n\r\n<iframe src=\"\/\/plugin.3playmedia.com\/show?mf=3935258&amp;p3sdk_version=1.10.1&amp;p=20361&amp;pt=375&amp;video_id=98ikG8a9JKs&amp;video_target=tpm-plugin-oxqlm4ic-98ikG8a9JKs\" width=\"800px\" height=\"520px\" frameborder=\"0\" marginwidth=\"0px\" marginheight=\"0px\"><\/iframe>\r\n\r\nYou can <a href=\"https:\/\/oerfiles.s3-us-west-2.amazonaws.com\/Lifespan+Development\/Transcriptions\/APGARscoreMEDZCOOL_transcript.txt\" target=\"_blank\" rel=\"noopener\">view the transcript for \"APGAR Score - MEDZCOOL\" here (opens in new window)<\/a>.\r\n\r\n<\/div>\r\n<h3>Low Birth Weight<\/h3>\r\n[caption id=\"attachment_6431\" align=\"alignright\" width=\"198\"]<img class=\"wp-image-6431\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/3707\/2019\/07\/23153003\/498px-Virginia_Apgar.jpg\" alt=\"Black and white photo from 1966 of Virginia Apgar listening to a newborn heartrate.\" width=\"198\" height=\"239\" \/> <strong>Figure 1<\/strong>. The Apgar score is named after physician Virginia Apgar, shown here with a newborn baby in 1966. The word was later turned into an acronym:\u00a0<b>A<\/b>ppearance (skin color),\u00a0<b>P<\/b>ulse (heart rate),\u00a0<b>G<\/b>rimace (reflex irritability),\u00a0<b>A<\/b>ctivity (muscle tone), and\u00a0<b>R<\/b>espiration.[\/caption]\r\n\r\nWe have been discussing a number of teratogens associated with a low birth weight such as cocaine, tobacco, etc. A child is considered to have a low birth weight if they weigh less than 5.8 pounds (2500 grams). About 8.17 percent of babies born in the United States are of low birth weight and 1.4 percent are born very low birth weight.[footnote]Birthweight and Gestation. Centers for Disease Control and Prevention (2016). Retrieved from <a href=\"https:\/\/www.cdc.gov\/nchs\/fastats\/birthweight.htm\" target=\"_blank\" rel=\"noopener\">https:\/\/www.cdc.gov\/nchs\/fastats\/birthweight.htm<\/a>[\/footnote] A low birth weight baby has difficulty maintaining adequate body temperature because it lacks the fat that would otherwise provide insulation. Such a baby is also at more risk of infection. And 67 percent of these babies are also preterm which can make them more at risk for a respiratory infection. Very low birth weight babies (2 pounds or less) have an increased risk of developing cerebral palsy.\u00a0Many causes of low birth weight are preventable with proper prenatal care.\r\n<h3>Premature Birth<\/h3>\r\nA child might also have a low birth weight if it is born at less than 37 weeks gestation (which qualifies it as a preterm baby). In 2016, 9.85 percent of babies born in the U.S. were preterm.[footnote]Birthweight and Gestation. Centers for Disease Control and Prevention (2016). Retrieved from <a href=\"https:\/\/www.cdc.gov\/nchs\/fastats\/birthweight.htm\" target=\"_blank\" rel=\"noopener\">https:\/\/www.cdc.gov\/nchs\/fastats\/birthweight.htm<\/a>[\/footnote] Early birth can be triggered by anything that disrupts the mother's system. For instance, vaginal infections or gum disease can actually lead to premature birth because such infection causes the mother to release anti-inflammatory chemicals which, in turn, can trigger contractions.\u00a0Smoking and the use of other teratogens can also lead to preterm birth.\r\n<h3>Anoxia and Hypoxia<\/h3>\r\nOne of leading causes of infant brain damage\u00a0is lack of oxygen shortly after birth. Hypoxia occurs when the infant is deprived of the adequate amount of oxygen, leading to mild to moderate brain damage. Anoxia occurs when the infant undergoes a total lack of oxygen,\u00a0which can lead to severe brain damage. This lack of oxygen is typically caused by umbilical cord problems, birth canal problems, blocked airways, and placenta abruption.\u00a0Both hypoxia and anoxia can lead to\u00a0cerebral palsy\u00a0and a host of other medical disorders.\u00a0[footnote]\u00a0Benaron, Harry B.W. et al. (1960). Effect of anoxia during labor and immediately after birth on the subsequent development of the child. American Journal of Obstetrics &amp; Gynecology, Volume 80, Issue 6, 1129 - 1142. Retrieved from\u00a0https:\/\/www.ajog.org\/article\/0002-9378(60)90080-6\/pdf[\/footnote]\r\n<div class=\"textbox tryit\">\r\n<h3>Try It<\/h3>\r\nhttps:\/\/assess.lumenlearning.com\/practice\/1d15dbdd-8c9b-49ea-8817-136c2d4273a1\r\n<\/div>","rendered":"<div class=\"textbox learning-objectives\">\n<h3>Learning Outcomes<\/h3>\n<ul>\n<li>Examine risks and complications with newborns<\/li>\n<\/ul>\n<\/div>\n<h2>Complications of the Newborn<\/h2>\n<h3>Assessing the Neonate<\/h3>\n<p>There are several ways to assess the condition of the newborn.\u00a0The most widely used tool is the\u00a0Neonatal Behavioral Assessment Scale\u00a0(NBAS) developed by T. Berry\u00a0Brazelton.\u00a0This tool has been used around the world to help parents get to know their infants and to make comparisons of infants in different cultures (Brazelton\u00a0&amp; Nugent, 1995).\u00a0The baby&#8217;s motor development, muscle\u00a0tone, and stress response are assessed.<\/p>\n<p>The\u00a0Apgar test is conducted one minute and five minutes after birth. This is a very quick way to assess the newborn&#8217;s overall condition. Five measures are assessed: the heart rate, respiration, muscle tone (quickly assessed by a skilled nurse when the baby is handed to them or by touching the baby&#8217;s palm), reflex response (the Babinski reflex is tested), and color. A score of 0 to 2 is given on each feature examined. An Apgar of 5 or less is cause for concern.\u00a0The second Apgar should indicate improvement with a higher score.<\/p>\n<div class=\"textbox examples\">\n<h3>Watch it<\/h3>\n<p>Watch this video that explains how to calculate the Apgar score for a newborn.<\/p>\n<p><iframe loading=\"lazy\" src=\"\/\/plugin.3playmedia.com\/show?mf=3935258&amp;p3sdk_version=1.10.1&amp;p=20361&amp;pt=375&amp;video_id=98ikG8a9JKs&amp;video_target=tpm-plugin-oxqlm4ic-98ikG8a9JKs\" width=\"800px\" height=\"520px\" frameborder=\"0\" marginwidth=\"0px\" marginheight=\"0px\"><\/iframe><\/p>\n<p>You can <a href=\"https:\/\/oerfiles.s3-us-west-2.amazonaws.com\/Lifespan+Development\/Transcriptions\/APGARscoreMEDZCOOL_transcript.txt\" target=\"_blank\" rel=\"noopener\">view the transcript for &#8220;APGAR Score &#8211; MEDZCOOL&#8221; here (opens in new window)<\/a>.<\/p>\n<\/div>\n<h3>Low Birth Weight<\/h3>\n<div id=\"attachment_6431\" style=\"width: 208px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-6431\" class=\"wp-image-6431\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/3707\/2019\/07\/23153003\/498px-Virginia_Apgar.jpg\" alt=\"Black and white photo from 1966 of Virginia Apgar listening to a newborn heartrate.\" width=\"198\" height=\"239\" \/><\/p>\n<p id=\"caption-attachment-6431\" class=\"wp-caption-text\"><strong>Figure 1<\/strong>. The Apgar score is named after physician Virginia Apgar, shown here with a newborn baby in 1966. The word was later turned into an acronym:\u00a0<b>A<\/b>ppearance (skin color),\u00a0<b>P<\/b>ulse (heart rate),\u00a0<b>G<\/b>rimace (reflex irritability),\u00a0<b>A<\/b>ctivity (muscle tone), and\u00a0<b>R<\/b>espiration.<\/p>\n<\/div>\n<p>We have been discussing a number of teratogens associated with a low birth weight such as cocaine, tobacco, etc. A child is considered to have a low birth weight if they weigh less than 5.8 pounds (2500 grams). About 8.17 percent of babies born in the United States are of low birth weight and 1.4 percent are born very low birth weight.<a class=\"footnote\" title=\"Birthweight and Gestation. Centers for Disease Control and Prevention (2016). Retrieved from https:\/\/www.cdc.gov\/nchs\/fastats\/birthweight.htm\" id=\"return-footnote-4895-1\" href=\"#footnote-4895-1\" aria-label=\"Footnote 1\"><sup class=\"footnote\">[1]<\/sup><\/a> A low birth weight baby has difficulty maintaining adequate body temperature because it lacks the fat that would otherwise provide insulation. Such a baby is also at more risk of infection. And 67 percent of these babies are also preterm which can make them more at risk for a respiratory infection. Very low birth weight babies (2 pounds or less) have an increased risk of developing cerebral palsy.\u00a0Many causes of low birth weight are preventable with proper prenatal care.<\/p>\n<h3>Premature Birth<\/h3>\n<p>A child might also have a low birth weight if it is born at less than 37 weeks gestation (which qualifies it as a preterm baby). In 2016, 9.85 percent of babies born in the U.S. were preterm.<a class=\"footnote\" title=\"Birthweight and Gestation. Centers for Disease Control and Prevention (2016). Retrieved from https:\/\/www.cdc.gov\/nchs\/fastats\/birthweight.htm\" id=\"return-footnote-4895-2\" href=\"#footnote-4895-2\" aria-label=\"Footnote 2\"><sup class=\"footnote\">[2]<\/sup><\/a> Early birth can be triggered by anything that disrupts the mother&#8217;s system. For instance, vaginal infections or gum disease can actually lead to premature birth because such infection causes the mother to release anti-inflammatory chemicals which, in turn, can trigger contractions.\u00a0Smoking and the use of other teratogens can also lead to preterm birth.<\/p>\n<h3>Anoxia and Hypoxia<\/h3>\n<p>One of leading causes of infant brain damage\u00a0is lack of oxygen shortly after birth. Hypoxia occurs when the infant is deprived of the adequate amount of oxygen, leading to mild to moderate brain damage. Anoxia occurs when the infant undergoes a total lack of oxygen,\u00a0which can lead to severe brain damage. This lack of oxygen is typically caused by umbilical cord problems, birth canal problems, blocked airways, and placenta abruption.\u00a0Both hypoxia and anoxia can lead to\u00a0cerebral palsy\u00a0and a host of other medical disorders.\u00a0<a class=\"footnote\" title=\"\u00a0Benaron, Harry B.W. et al. (1960). Effect of anoxia during labor and immediately after birth on the subsequent development of the child. American Journal of Obstetrics &amp; Gynecology, Volume 80, Issue 6, 1129 - 1142. Retrieved from\u00a0https:\/\/www.ajog.org\/article\/0002-9378(60)90080-6\/pdf\" id=\"return-footnote-4895-3\" href=\"#footnote-4895-3\" aria-label=\"Footnote 3\"><sup class=\"footnote\">[3]<\/sup><\/a><\/p>\n<div class=\"textbox tryit\">\n<h3>Try It<\/h3>\n<p>\t<iframe id=\"assessment_practice_1d15dbdd-8c9b-49ea-8817-136c2d4273a1\" class=\"resizable\" src=\"https:\/\/assess.lumenlearning.com\/practice\/1d15dbdd-8c9b-49ea-8817-136c2d4273a1?iframe_resize_id=assessment_practice_id_1d15dbdd-8c9b-49ea-8817-136c2d4273a1\" frameborder=\"0\" style=\"border:none;width:100%;height:100%;min-height:300px;\"><br \/>\n\t<\/iframe>\n<\/div>\n\n\t\t\t <section class=\"citations-section\" role=\"contentinfo\">\n\t\t\t <h3>Candela Citations<\/h3>\n\t\t\t\t\t <div>\n\t\t\t\t\t\t <div id=\"citation-list-4895\">\n\t\t\t\t\t\t\t <div class=\"licensing\"><div class=\"license-attribution-dropdown-subheading\">CC licensed content, Original<\/div><ul class=\"citation-list\"><li>Modification, adaptation, and original content. <strong>Authored by<\/strong>: Julie Lazzara for Lumen Learning. <strong>Provided by<\/strong>: Lumen Learning. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\">CC BY: Attribution<\/a><\/em><\/li><\/ul><div class=\"license-attribution-dropdown-subheading\">CC licensed content, Shared previously<\/div><ul class=\"citation-list\"><li>Psyc 200 Lifespan Psychology. <strong>Authored by<\/strong>: Laura Overstreet. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"http:\/\/opencourselibrary.org\/econ-201\/\">http:\/\/opencourselibrary.org\/econ-201\/<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\">CC BY: Attribution<\/a><\/em><\/li><\/ul><div class=\"license-attribution-dropdown-subheading\">All rights reserved content<\/div><ul class=\"citation-list\"><li>APGAR Score - MEDZCOOL. <strong>Authored by<\/strong>: Medzcool. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/www.youtube.com\/watch?v=98ikG8a9JKs\">https:\/\/www.youtube.com\/watch?v=98ikG8a9JKs<\/a>. <strong>License<\/strong>: <em>Other<\/em>. <strong>License Terms<\/strong>: Standard YouTube License<\/li><\/ul><div class=\"license-attribution-dropdown-subheading\">Public domain content<\/div><ul class=\"citation-list\"><li>Assessing newborn. <strong>Authored by<\/strong>: Phillip A. Jones. <strong>Provided by<\/strong>: U.S. Army Photo. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/www.army.mil\/article\/30842\/neonatal_intensive_care_unit_in_action_at_lrmc\">https:\/\/www.army.mil\/article\/30842\/neonatal_intensive_care_unit_in_action_at_lrmc<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/about\/pdm\">Public Domain: No Known Copyright<\/a><\/em><\/li><\/ul><\/div>\n\t\t\t\t\t\t <\/div>\n\t\t\t\t\t <\/div>\n\t\t\t <\/section><hr class=\"before-footnotes clear\" \/><div class=\"footnotes\"><ol><li id=\"footnote-4895-1\">Birthweight and Gestation. Centers for Disease Control and Prevention (2016). Retrieved from <a href=\"https:\/\/www.cdc.gov\/nchs\/fastats\/birthweight.htm\" target=\"_blank\" rel=\"noopener\">https:\/\/www.cdc.gov\/nchs\/fastats\/birthweight.htm<\/a> <a href=\"#return-footnote-4895-1\" class=\"return-footnote\" aria-label=\"Return to footnote 1\">&crarr;<\/a><\/li><li id=\"footnote-4895-2\">Birthweight and Gestation. Centers for Disease Control and Prevention (2016). Retrieved from <a href=\"https:\/\/www.cdc.gov\/nchs\/fastats\/birthweight.htm\" target=\"_blank\" rel=\"noopener\">https:\/\/www.cdc.gov\/nchs\/fastats\/birthweight.htm<\/a> <a href=\"#return-footnote-4895-2\" class=\"return-footnote\" aria-label=\"Return to footnote 2\">&crarr;<\/a><\/li><li id=\"footnote-4895-3\">\u00a0Benaron, Harry B.W. et al. (1960). Effect of anoxia during labor and immediately after birth on the subsequent development of the child. American Journal of Obstetrics &amp; Gynecology, Volume 80, Issue 6, 1129 - 1142. Retrieved from\u00a0https:\/\/www.ajog.org\/article\/0002-9378(60)90080-6\/pdf <a href=\"#return-footnote-4895-3\" class=\"return-footnote\" aria-label=\"Return to footnote 3\">&crarr;<\/a><\/li><\/ol><\/div>","protected":false},"author":29,"menu_order":13,"template":"","meta":{"_candela_citation":"[{\"type\":\"cc\",\"description\":\"Psyc 200 Lifespan Psychology\",\"author\":\"Laura Overstreet\",\"organization\":\"\",\"url\":\"http:\/\/opencourselibrary.org\/econ-201\/\",\"project\":\"\",\"license\":\"cc-by\",\"license_terms\":\"\"},{\"type\":\"pd\",\"description\":\"Assessing newborn\",\"author\":\"Phillip A. Jones\",\"organization\":\"U.S. Army Photo\",\"url\":\"https:\/\/www.army.mil\/article\/30842\/neonatal_intensive_care_unit_in_action_at_lrmc\",\"project\":\"\",\"license\":\"pd\",\"license_terms\":\"\"},{\"type\":\"original\",\"description\":\"Modification, adaptation, and original content\",\"author\":\"Julie Lazzara for Lumen Learning\",\"organization\":\"Lumen Learning\",\"url\":\"\",\"project\":\"\",\"license\":\"cc-by\",\"license_terms\":\"\"},{\"type\":\"copyrighted_video\",\"description\":\"APGAR Score - MEDZCOOL\",\"author\":\"Medzcool\",\"organization\":\"\",\"url\":\"https:\/\/www.youtube.com\/watch?v=98ikG8a9JKs\",\"project\":\"\",\"license\":\"other\",\"license_terms\":\"Standard YouTube License\"}]","CANDELA_OUTCOMES_GUID":"3121881b-2d56-41f5-8f7a-162f6507117f, 6c4181a2-a541-41d9-ae4e-860dc2328983","pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[],"contributor":[],"license":[],"class_list":["post-4895","chapter","type-chapter","status-publish","hentry"],"part":156,"_links":{"self":[{"href":"https:\/\/courses.lumenlearning.com\/wm-lifespandevelopment\/wp-json\/pressbooks\/v2\/chapters\/4895","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/courses.lumenlearning.com\/wm-lifespandevelopment\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/courses.lumenlearning.com\/wm-lifespandevelopment\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/courses.lumenlearning.com\/wm-lifespandevelopment\/wp-json\/wp\/v2\/users\/29"}],"version-history":[{"count":14,"href":"https:\/\/courses.lumenlearning.com\/wm-lifespandevelopment\/wp-json\/pressbooks\/v2\/chapters\/4895\/revisions"}],"predecessor-version":[{"id":7750,"href":"https:\/\/courses.lumenlearning.com\/wm-lifespandevelopment\/wp-json\/pressbooks\/v2\/chapters\/4895\/revisions\/7750"}],"part":[{"href":"https:\/\/courses.lumenlearning.com\/wm-lifespandevelopment\/wp-json\/pressbooks\/v2\/parts\/156"}],"metadata":[{"href":"https:\/\/courses.lumenlearning.com\/wm-lifespandevelopment\/wp-json\/pressbooks\/v2\/chapters\/4895\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/courses.lumenlearning.com\/wm-lifespandevelopment\/wp-json\/wp\/v2\/media?parent=4895"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/courses.lumenlearning.com\/wm-lifespandevelopment\/wp-json\/pressbooks\/v2\/chapter-type?post=4895"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/courses.lumenlearning.com\/wm-lifespandevelopment\/wp-json\/wp\/v2\/contributor?post=4895"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/courses.lumenlearning.com\/wm-lifespandevelopment\/wp-json\/wp\/v2\/license?post=4895"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}