复旦大学上海医学院 儿科学系
周蓓华
Neonate and Neonatal diseases
Neonatal outline
development of neonatology
? Important branch of pediatrics
? Rapid development
? Expectation and danger
? Challenge extremity of life
N I CU
Neonatal period (新生儿期 )
Neonate,newborn (新生儿 )
Neonatology (新生儿学 )
Perinatal period (围产期 )
Perinatal infant (围产儿 )
Perinatology (围产医学 )
Concepts
N I CU
Classification of Newborn
１,Gestational age ( 胎龄 )
足月儿,fullterm infant,mature infant
≥37w～ < 42w
早产儿,preterm infant,premature infant
< 37w
过期产儿,postterm infant
? 42w
N I CU
２,Birth weight (出生体重 )
normal birth weight,2500-3999g
low birth weight(LBW),<2500g
very low birth weight(VLBW),<1500g
extremely low birth weight(ELBW),< 1000g
macrosomia,? 4000克
N I CU
３,Relation of birth weight and gestational age
Appropriate for gestational age (AGA)：
10－ 90 percentage
Small for gestational age (SGA),< 10 percentage
Large for gestational age (LGA),> 90 percentage
N I CU
４,Day after birth
? Early newborn,１ week
70% death is during １ week
? Lately newborn,2 - 4 week
N I CU
５,High risk newborns
? High risk factors
? monitor
N I CU
respiratory system
? Respiratory center
? Pulmonary surfactant
(肺表面活性物质 )
? Respiratory rate,40-45/min
? Abdomen respiratory
N I CU
gastrointestinal system
? Stomach,loosely Lower esophageal
sphincter
? Air in intestine
? Meconium (胎粪）
? Glucuronyl transferase (葡萄糖醛酸转移酶 )
N I CU
Blood system
? Polycythermia,HbF（ fetal hemoglobin)70%
? Leukocyte
? Low coagulation factors
N I CU
Urinary system
? Concentration of urine
? Urinate <24h
N I CU
Nervous system
Reflexes
Moro,rooting,sucking
N I CU
Immuno- system
? IgG from mother
? IgM can’t through placenta
? IgA
? Cellular immunity
N I CU
neutral temperature （适中温度 ）
指在这一 room temperature下，机体耗氧量、代谢
率最低，散热量最少，而又能保持正常体温。
newborn,33－ 35oC
adult, 25－ 26oC
N I CU
出生体重
（ kg ）
暖 箱 温 度
35 ℃ 34 ℃ 33 ℃ 32 ℃
1.0
初生 10 天
10 天以后
3 周以后
5 周以后
1.5
－
初生 10 天
10 天以后
4 周以后
2.0
－
初生 2 天
2 天以后
3 周以后
2.5
－
－
初生 2 天
2 天以后
neutral temperature
N I CU
Special physiology
physiologic jaundice
breast greater
N I CU
care of normal newborn
? roting care
? Special care
? Neonatal Intensive Care Unit
NICU
N I CU
Care of normal newborn
1,ward,room temperature,22－ 26oC，
humidity 40－ 50 ％
2,infection,sterilizing,wash hand
3,keeping temperature,incubator
4,skin care,wash with water
5,umbilical cord,sterilizing,keep dry
N I CU
6.feeding
breast feeding,bottle feeding
7,vaccine,BCG, Hepatitis B
8.neonatal screening：
PKU,hypothyroidism,hearing
N I CU
Respiratory system
? Premature of respiratory center
? Abdominal respiration
? Apnea
? RDS
N I CU
gastrointestinal system
? Vomiting and aspiration
? Gastroesphageal reflux (GER)
? Feeding difficulty
? NEC (necrotizing enterocolitis)
N I CU
Nervous system
? Development and gestational age
? IVH and PVL
N I CU
Cardiovascular system
? delay close of PDA
Other
? Hypoglycemian
? hypocalcemia
? Difficincy vitaming A,E
? Difficincy Glucuronyl transferase
N I CU
Problems of premature infants
? temperature
? hypoglycemia
? Cardiovascular system
? Respiratory system
? Water,
? kedney
? Blood system
? infections
? gastrointestinal system
? jaundice
? Nervous system
? ROP
? feeding
N I CU
Care of premature infants
1,ward,sterilizing,wash hand
2,feeding,milk，
3,Keeping temperature
4,Monitor,
N I CU
SGA, small for gestational age
1,Etiology
factors,mother
fetus
2,Manifestation
匀称型
非匀称型
N I CU
small for gestational age
3,Complications
hypoglycemia,hypocalcemia
polycythemia (RBC增多症 )
aspiration,NEC
development delay
N I CU
LGA, Large for gestational age
factors
1,physiology：
parents
over nutrition
2,diabetes mother：
high insulin，
rapid growth
N I CU
Complications
NRDS：
Birth injury
Hypoglycemia
N I CU
周蓓华
Neonate and Neonatal diseases
Neonatal outline
development of neonatology
? Important branch of pediatrics
? Rapid development
? Expectation and danger
? Challenge extremity of life
N I CU
Neonatal period (新生儿期 )
Neonate,newborn (新生儿 )
Neonatology (新生儿学 )
Perinatal period (围产期 )
Perinatal infant (围产儿 )
Perinatology (围产医学 )
Concepts
N I CU
Classification of Newborn
１,Gestational age ( 胎龄 )
足月儿,fullterm infant,mature infant
≥37w～ < 42w
早产儿,preterm infant,premature infant
< 37w
过期产儿,postterm infant
? 42w
N I CU
２,Birth weight (出生体重 )
normal birth weight,2500-3999g
low birth weight(LBW),<2500g
very low birth weight(VLBW),<1500g
extremely low birth weight(ELBW),< 1000g
macrosomia,? 4000克
N I CU
３,Relation of birth weight and gestational age
Appropriate for gestational age (AGA)：
10－ 90 percentage
Small for gestational age (SGA),< 10 percentage
Large for gestational age (LGA),> 90 percentage
N I CU
４,Day after birth
? Early newborn,１ week
70% death is during １ week
? Lately newborn,2 - 4 week
N I CU
５,High risk newborns
? High risk factors
? monitor
N I CU
respiratory system
? Respiratory center
? Pulmonary surfactant
(肺表面活性物质 )
? Respiratory rate,40-45/min
? Abdomen respiratory
N I CU
gastrointestinal system
? Stomach,loosely Lower esophageal
sphincter
? Air in intestine
? Meconium (胎粪）
? Glucuronyl transferase (葡萄糖醛酸转移酶 )
N I CU
Blood system
? Polycythermia,HbF（ fetal hemoglobin)70%
? Leukocyte
? Low coagulation factors
N I CU
Urinary system
? Concentration of urine
? Urinate <24h
N I CU
Nervous system
Reflexes
Moro,rooting,sucking
N I CU
Immuno- system
? IgG from mother
? IgM can’t through placenta
? IgA
? Cellular immunity
N I CU
neutral temperature （适中温度 ）
指在这一 room temperature下，机体耗氧量、代谢
率最低，散热量最少，而又能保持正常体温。
newborn,33－ 35oC
adult, 25－ 26oC
N I CU
出生体重
（ kg ）
暖 箱 温 度
35 ℃ 34 ℃ 33 ℃ 32 ℃
1.0
初生 10 天
10 天以后
3 周以后
5 周以后
1.5
－
初生 10 天
10 天以后
4 周以后
2.0
－
初生 2 天
2 天以后
3 周以后
2.5
－
－
初生 2 天
2 天以后
neutral temperature
N I CU
Special physiology
physiologic jaundice
breast greater
N I CU
care of normal newborn
? roting care
? Special care
? Neonatal Intensive Care Unit
NICU
N I CU
Care of normal newborn
1,ward,room temperature,22－ 26oC，
humidity 40－ 50 ％
2,infection,sterilizing,wash hand
3,keeping temperature,incubator
4,skin care,wash with water
5,umbilical cord,sterilizing,keep dry
N I CU
6.feeding
breast feeding,bottle feeding
7,vaccine,BCG, Hepatitis B
8.neonatal screening：
PKU,hypothyroidism,hearing
N I CU
Respiratory system
? Premature of respiratory center
? Abdominal respiration
? Apnea
? RDS
N I CU
gastrointestinal system
? Vomiting and aspiration
? Gastroesphageal reflux (GER)
? Feeding difficulty
? NEC (necrotizing enterocolitis)
N I CU
Nervous system
? Development and gestational age
? IVH and PVL
N I CU
Cardiovascular system
? delay close of PDA
Other
? Hypoglycemian
? hypocalcemia
? Difficincy vitaming A,E
? Difficincy Glucuronyl transferase
N I CU
Problems of premature infants
? temperature
? hypoglycemia
? Cardiovascular system
? Respiratory system
? Water,
? kedney
? Blood system
? infections
? gastrointestinal system
? jaundice
? Nervous system
? ROP
? feeding
N I CU
Care of premature infants
1,ward,sterilizing,wash hand
2,feeding,milk，
3,Keeping temperature
4,Monitor,
N I CU
SGA, small for gestational age
1,Etiology
factors,mother
fetus
2,Manifestation
匀称型
非匀称型
N I CU
small for gestational age
3,Complications
hypoglycemia,hypocalcemia
polycythemia (RBC增多症 )
aspiration,NEC
development delay
N I CU
LGA, Large for gestational age
factors
1,physiology：
parents
over nutrition
2,diabetes mother：
high insulin，
rapid growth
N I CU
Complications
NRDS：
Birth injury
Hypoglycemia
N I CU
