20th International Conference on Neonatology and Perinatology December 04-06, 2017 Madrid, Spain

Perinatology is a subspecialty of obstetrics concerned with the care of the fetus and complicated, high-risk pregnancies. Perinatology is also known as maternal-fetal medicine. Since the perinatal period, depending on the definition, starts at the 20th to 28th week of gestation and ends 1 to 4 weeks after birth, perinatology logically could be an obstetrical and pediatric subspecialty but, in practice, it is part of obstetrics. The comparable area of pediatrics is neonatology. A high-risk baby might be cared for by a perinatologist before birth and by a neonatologist after birth.

Premature babies are the ones who are born before the 37th week of gestation. Premature babies experience many complications which can be short-term or long-term complication. The earlier the baby is born the many are the risk of complications. These complications can be treated in the neonatal intensive care unit (NICU). Some of the major premature complications include immature lungs, respiratory distress syndrome, bronchopulmonary dysplasia.

A neonatal intensive care unit (NICU), also known as an intensive care nursery (ICN), is an intensive care unit specializing in the care of ill or premature newborn infants. A NICU is typically directed by one or more neonatologists and staffed by nurses, nurse practitioners, pharmacists, physician assistants, resident physicians, respiratory therapists, and dietitians. Many other ancillary disciplines and specialists are available at larger units.

A Neonatal nurse practitioner are advanced practice nurses that care for premature babies and sick newborns in intensive care units, emergency rooms, delivery rooms and special clinics.

Nutrition plays and important factor especially in the first couple weeks of life. Breast Feeding has important ingredients that build the baby’s immune system.  Neonatal nutrition is important for the growth and development of the newborn babies. In general, babies should be atleast 4 pounds before they are ready to come out of the incubator.

Neonatal surgery is the sub-specialty of pediatric surgery that includes the surgical care of newborn infants especially new born who are ill. Neonatal surgeons are the ones who perform surgeries including chest, abdominal and urological defects. Neonatal surgery includes the treatment of infants in the first 28 days of birth.

Respiratory distress in the neonate most commonly presents as one or all of the following physical signs: tachypnea, grunting, nasal flaring, retractions, and cyanosis. A normal respiratory rate in a new-born is between 30 and 60 breaths/min; tachypnea is classified as respiratory rates greater than 60 breaths/min. 

Neonatal respiratory distress syndrome (RDS) is a problem often seen in premature babies. The condition makes it hard for the baby to breathe. The disease is mainly caused by a lack of a slippery substance in the lungs called surfactant. This substance helps the lungs fill with air and keeps the air sacs from deflating.Surfactant is present when the lungs are fully developed.

Neonatal infections are infections of the neonate (newborn) during the neonatalperiod or first four weeks after birth. Neonatal infections may be contracted by transplacental transfer in utero, in the birth canal during delivery (perinatal), or by other means after birth.Some infections acquired in the neonatal period do not become apparent until much later such as HIV, hepatitis B and malaria.

There is a higher risk of infection with preterm or low birth weight neonates. Respiratory tract infections contracted by preterm neonates may continue into childhood or possibly adulthood with long-term effects that limit one's ability to engage in normal physical activities, decreasing one's quality of life and increasing health care costs. In some instances, neonatal respiratory tract infections may increase one's susceptibility to future respiratory infections and inflammatory responses related to lung disease

Neonatal Research is research to improve the Health of Low Birth Weight and Premature Infants. Neonatal Research includes trials of therapies for sepsis, intraventricular hemorrhage, chronic lung disease, and pulmonary hypertension as well as studies of the impact of drug exposure on child and family outcome.

New-born babies are able to follow a light with their eyes and turn toward lights. They are very near-sighted at first, and they can focus best on things that are within 25 cm (10 inches) of their faces. Their vision improves over the first three months. In time, his ability to focus will improve and he will see as well as the rest of us.

There are a few things that you might be concerned about, with regard to your new-born baby’s eyes:uncoordinated eyes, crossed eyes, and teary eyes.

Eye problems in babies may be congenital (usually genetic or through intrauterine insult) or acquired after birth. Early detection and prompt treatment are essential, in order to avoid lifelong visual impairment. The eyes should be examined at the first neonatal check, when babies should be examined for structural abnormalities such as cataract, corneal opacity, ptosis and retinoblastoma, again at the six-week check, and at every well-child screening visit. Any child with an ocular abnormality should be referred to an ophthalmologist specialising in paediatric patients.

Neonatal Abstinence Syndrome. Fetal and neonatal addiction and withdrawal as a result of the mother's dependence on drugs during pregnancy. Withdrawal or abstinence symptoms develop shortly after birth. Symptoms exhibited are loud, high-pitched crying, sweating, yawning and gastrointestinal disturbances.

The central nervous system of a growing foetus starts with a simple structure called the ‘neural groove’ that folds in to form the ‘neural tube’. This then develops into the spinal cord and brain. By day 28 after conception, the neural tube should be closed and fused. If it doesn’t close, the result is a neural tube defect. 
In many cases, these defects can be diagnosed during pregnancy with ultrasound scans and, rarely, with other tests such as amniocentesis (analysing a sample of amniotic fluid).

Acute renal failure (ARF) is a very common problem in the neonatal intensive care unit. The new-born kidney has a very low glomerular filtration rate (GFR) that is maintained by a delicate balance between vasoconstrictor and vasodilatory forces. Although sufficient for growth and development under normal conditions, the low GFR of the new-born kidney limits postnatal renal functional adaptation to endogenous and exogenous stresses. This limited response predisposes the new-born to the development of ARF and is even more pronounced in the low birth weight infant (ie, <2,500 g due to preterm birth or intrauterine growth restriction). Given this predisposition, early identification of ARF in the neonate is essential to preserving renal function.

Congenital heart disease (CHD) is the most common congenital disorder in new-borns. Critical CHD, defined as requiring surgery or catheter-based intervention in the first year of life, occurs in approximately 25% of those with CHD. Although many new-borns with critical CHD are symptomatic and identified soon after birth, others are not diagnosed until after discharge from the birth hospitalization . In infants with critical cardiac lesions, the risk of morbidity and mortality increases when there is a delay in diagnosis and timely referral to a tertiary center with expertise in treating these patients.

Neonatal skin is structurally unique. Dermatological diseases in neonates are commonly benign and self limiting, but they may also herald underlying systemic disease and can be life threatening. Transient neonatal pustular melanosis is a benign, idiopathic skin condition characterized by vesicles, superficial pustules, and pigmentedmacules. The overall incidence is 2.2%, equally divided between sexes, with rates of 0.6% in white and 4.4% in black infants. Skin conditions are seen frequently throughout childhood, from infancy through adolescence. There are many causes, including infection and inflammation. Rashes, birthmarks, and other skin conditions are encountered frequently in infancy. Most new-born rashes are benign and require no treatment.

Neonatal screening is a  screening in infants shortly after birth for a list of conditions that are treatable, but not clinically evident in the newborn period. Some of the conditions included in newborn screening programs are only detectable after irreversible damage has been done, in some cases sudden death is the first manifestation of a disease. Screening programs are often run by state or national governing bodies with the goal of screening all infants born in the jurisdiction. 

Newborn screening originated with an amino acid disorder, phenylketonuria (PKU), which can be easily treated by dietary modifications, but causes severe mental retardation if not identified and treated early

Newborns have an immature immune system that renders them at high risk for infection while simultaneously reducing responses to most vaccines, thereby posing challenges in protecting this vulnerable population. A vaccine is an antigenic preparation used to produce active immunity to a disease, in order to prevent or reduce the effects of infection by any natural or "wild" pathogen. Many vaccines require multiple doses for maximum effectiveness, either to produce sufficient initial immune response or to boost response that fades over time. For example, tetanus vaccine boosters are often recommended every 10 years. Vaccine schedules are developed by governmental agencies or physicians groups to achieve maximum effectiveness using required and recommended vaccines for a locality while minimizing the number of health care system interactions.

A neonatal death is defined as a death during the first 28 days of life (0-27 days). The NMR is often broken down into early and late mortality rates. Perinatal mortality (PNM), also perinatal death, refers to the death of a fetus or neonate and is the basis to calculate the perinatal mortality rate. Variations in the precise definition of the perinatal mortality exist specifically concerning the issue of inclusion or exclusion of early fetal and late neonatal fatalities. Preterm birth is the most common cause of perinatal mortality, causing almost 30 percent of neonatal deaths.Infant respiratory distress syndrome, in turn, is the leading cause of death in preterm infants, affecting about 1% of newborn infants.Birth defects cause about 21 percent of neonatal death.