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Summary Infancy. Task 9. Psychpathology in Early Development
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Infancy Task 9 Psychopathology in early developmentLearning goals:
1. Prematurity and risk factors
2. Consequences of premature birth
3. Childhood disintegrative disorder
1. Prematurity and risk factors
WHO: when birth weight below 2500 g and born before 37 weeks of gestation. Subgroups:
1. Preterm AGA: Born before 37 weeks and weight appropriate for gestational age
2. Preterm SGA: born before 37 weeks whose weight is small for gestational age, also
called small-for-date
3. VLBW: Very low birth weight: below 1500 g
ELBW: extremely low birth weight: below 1000 g
IUGR: intra-uterine growth retardation: birth weight falling below the tenth percentile
for gestational age
5-8% of infants in US and Europe are born before 37 weeks and have birth weights below
2500 g. 1% are born with VLBW. In wealthy societies most LBW infants are born preterm,
in developing countries most due to IUGR.
Risk factors
- Mother’s age (younger than 20 or older than 35)
- Previous pregnancy history (previous preterm birth enlarges chance of another)
- Smoking (during second half of pregnancy associated with decrease of 200g)
- Weight gain before and during pregnancy
- Birth order
- Family income (lower income higher risk)
- Education (lower education higher risk)
Highest risk when: complication of pregnancy and labor, high weight gain or high
prepregnancy weight, smoking and fetal attributes.
2. Consequences of premature birth
Biggest risks after birth: respiratory problems because of immaturity of the lungs.
Infants can tolerate no more than 8 minutes of anoxia (lack of oxygen), after this they get
brain injuries. Partial deprivation of oxygen (hypoxia) is more subtle but is equally
threatening. When not treated, small areas of brain circulation are closed down with
permanent loss of function. May result in severe disabilities including early seizures,
spasticity or hypotonia.
VLBW, ELBW and IUGR: can be as young as 24 weeks and weigh between 500 and 1500g.
Failure to grow may be due to impaired fetal oxygen or nutrient transport or the exchange of
metabolic waste and is influenced by maternal conditions as toxemia, smoking, drug and
alcohol use, viral infections, structural features of uterus or placenta or fetal abnormalities.
Preterms with weight appropriate for age usually catch up in growth, IUGR infants remain
smaller. VLBW is succeptible to all sort of complications.
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