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Perspectives of

Pediatric Nursing
ERNIE B. GUEVARRA, M.D.

Mosby items and derived items © 2005, 2001 by Mosby, Inc.


DEFINITION OF TERMS
Live Birth: the complete expulsion or
extraction from the mother of the product
of conception, irrespective of the duration
of pregnancy, which after expulsion or
extraction breaths or shows any evidence
of life.

Mosby items and derived items © 2005, 2001 by Mosby, Inc.


DEFINITION OF TERMS
Fetal Death: death prior to the complete
expulsion or extraction from the mother of
the product of human conception, fetus or
embryo, irrespective of the duration of
pregnancy

Mosby items and derived items © 2005, 2001 by Mosby, Inc.


FETAL DEATH

Early Fetal Death: death prior to the


complete expulsion or extraction from the
mother of fetus or embryo weighing 500
gm or less (about 20 weeks gestation)

Mosby items and derived items © 2005, 2001 by Mosby, Inc.


FETAL DEATH

Late Fetal Death (Still Birth): death prior


to the complete expulsion or extraction
from the mother in which fetal weight is
greater than 500 gm or if the weight is
unknown, the duration of pregnancy
exceeds 20 weeks of gestation and a
body length of > 25 cm (crown-heel)

Mosby items and derived items © 2005, 2001 by Mosby, Inc.


Infant Mortality
• Definition: Number of deaths per 1000
live births during first year of life (364
days, 23 hours, 59 minutes from the
moment of birth)
– Neonatal period: <28 days of life
– Postnatal period: 28 days to 1 year

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NEONATAL DEATHS
– Early Neonatal death: death of a live
born neonate during the 1st 7 days
from the moment of birth
– Late Neonatal Death: death of a
liveborn neonate after seven
completed days (168 hours) but
before 28 days of life

Mosby items and derived items © 2005, 2001 by Mosby, Inc.


DEFINITION OF TERMS
Gestational Age: number of completed
weeks that have elapsed between the
first day of the last menstrual period and
the date of delivery

Mosby items and derived items © 2005, 2001 by Mosby, Inc.


DEFINITION OF TERMS
Preterm Neonate: any neonate whose GA
calculated from the 1st day of LMP, is
< 37 completed weeks or < 259
completed days, irrespective of weight at
birth

Mosby items and derived items © 2005, 2001 by Mosby, Inc.


DEFINITION OF TERMS
• Term Neonate: any neonate whose GA
calculated from the 1st day of LMP, is
equal to or > than 37 wks and =/< 42 wks
(259 to 294) days, irrespective of wt at
birth

Mosby items and derived items © 2005, 2001 by Mosby, Inc.


DEFINITION OF TERMS

• Post term Neonate: any neonate whose


GA calculated from the 1st day of LMP, is
> 42 wks of gestation (=/> 259 days)
irrespective of wt at birth)

Mosby items and derived items © 2005, 2001 by Mosby, Inc.


Birth Weight
• Major determinant of neonatal death in
the Philippines.
• LBW: <2500 g
• VLBW: 1000-1500 g
• ELBW: <1000g

• Lower birth weight = Higher mortality

Mosby items and derived items © 2005, 2001 by Mosby, Inc.


Other Risk Factors for
Infant Mortality
• Male gender
• Short or long gestation
• Birth order
• Maternal age (younger or older)
• Maternal education
• Black race

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Childhood Mortality
• Injuries are leading cause of death in age
>1 year
– Motor vehicle crashes
– Drowning
– Burns
– Poisoning
– Firearms

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INFANT MORTALITY
Ten (10) Leading Causes
Number & Rate/1000 Livebirths & Percentage Distribution
Philippines, 2004

Cause Percent
5. Bacterial sepsis of newborn 15.1
6. Respiratory distress of newborn 11.1
7. Pneumonia 8.6
8. Disorders related to short gestation and low birth weight, not elsewhere
classified 7.8
9. Congenital Pneumonia 6.7
10. Congenital malformation of the heart 6.4
11. Neonatal aspiration syndrome 5.6
12. Other congenital malformation 4.8
13. Intrauterine hypoxia and birth asphyxia 4.6
14. Diarrhea and gastro-enterities of presumed
infectious origin 4.1

Source: The 2004 Philippine Health Statistics


* percent share from total infant deaths, all causes, Philippines
Last Update: February 12, 2008

Mosby items and derived items © 2005, 2001 by Mosby, Inc.


Childhood Morbidity
• May denote acute illness, chronic
disease, or disability
• Difficult to define and measure
• The “new morbidity”
– Social, behavioral, educational
problems that may alter health

Mosby items and derived items © 2005, 2001 by Mosby, Inc.

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