Neonatology and Perinatology

Neonatology is a subspecialty of pediatrics that consists of the medical care of new-born infants, especially the ill or premature new-born. It is a hospital-based specialty, and is usually practiced in neonatal intensive care units (NICUs).The principal patients of neonatologists are new-born infants who are ill or require special medical care due to prematurity, low birth weight, intrauterine growth restriction etc.

The most number of affected pregnant women is increasing, but scarce information is available about the clinical features Obstetric and neonatal outcomes of pregnant patients with COVID-19 in pregnancy caused by severe acute respiratory syndrome coronavirus Moreover maternal, fetal, and neonatal outcomes of patients who were infected in late pregnancy appeared very good, and these outcomes were achieved with intensive, active management that might be the best practice in the absence of more robust data. The clinical characteristics of these patients with COVID-19 during pregnancy were similar to those of non-pregnant adults with COVID-19 clinical symptoms from 33 neonates with or at risk of COVID-19 were mild and outcomes were favourable of the 3 neonates with symptomatic COVID-19, presented with early-onset SARS-CoV-2 infection. Because strict infection control and prevention procedures were implemented during the delivery, it is likely that the sources of SARS-CoV-2 in the clinical findings or investigations suggestive of COVID-19 in neonates born to affected mothers, and all samples, including amniotic fluid, cord blood, and breast milk, were negative for SARS-CoV-2.

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 20^th to 28^th 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 Perinatologists before birth and by a neonatologist after birth.

Pediatrics is one of the fields of medicine which is concerned with the medical, health care and development of babies and children and their opportunity to get complete potential to grow into adults. Pediatrics follows the age range from infants to adolescents. Pediatrics is the newly emerged medical specialty. The main aim of the Paediatrics is to reduce the child and infant death rates, to control the spreading of infectious diseases and to promote healthy life styles. Pediatrics is not only concerned about the immediate cure but also the long term effects on quality life, abilities and survival.

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 new-born 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.

Neonatal nurse practitioners are advanced practice nurses that care for premature babies and sick new-borns in intensive care units, emergency rooms, delivery rooms and special clinics. Prematurity is a risk factor that follows early labour, a planned caesarean section or pre-eclampsia.

A congenital disorder, also known as a congenital disease, deformity, birth defect, or anomaly, is a condition existing at or before birth regardless of cause. Of these disorders, those characterized by structural deformities are termed "congenital anomalies" and involve defects in a developing fetus. Birth defects vary widely in cause and symptoms. Any substance that causes birth defects is known as a teratogen. Some disorders can be detected before birth through prenatal diagnosis (screening).

Birth defects may be the result of genetic or environmental factors. This includes errors of morphogenesis, infection, epigenetic modifications on a parental germline, or a chromosomal abnormality. The outcome of the disorder will depend on complex interactions between the pre-natal deficit and the post-natal environment. Animal studies indicate that the mother's (and likely the father's) diet, vitamin intake, and glucose levels prior to ovulation and conception have long-term effects on fetal growth and adolescent and adult disease. Animal studies have shown that paternal exposures prior to conception and during pregnancy result in increased risk of certain birth defects and cancers.

Infant mortality is the death of young children under the age of 1. This death toll is measured by the infant mortality rate, which is the number of deaths of children less than one year of age per 1000 live births. Neonatal nursing is a subspecialty of nursing that works with new-born infants born with a variety of problems ranging from prematurity, birth defects, infection, cardiac malformations, and surgical problems. The neonatal period is defined as the first month of life; however, these new-borns are often sick for months. Neonatal nursing generally encompasses care for those infants who experience problems shortly after birth, but it also encompasses care for infants who experience long-term problems related to their prematurity or illness after birth.

A few neonatal nurses may care for infants up to about 2 years of age. Most neonatal nurses care for infants from the time of birth until they are discharged from the hospital. 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.

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.

Some congenital heart problems are now picked up when the mother has an ultrasound scan during pregnancy (usually at the 20-week scan), but sometimes they are not found until after the baby has been born. Some conditions may not be discovered until the child is older or even an adult.

Fetal nutrition is one of these factors: the complex interaction between genetic growth potential, the ability of the maternal–placental system to transfer nutrients to the fetus and the endocrine environment determine whether the fetus will follow its growth potential during intrauterine life.

New-born screening is a screening in infants shortly after birth for a list of conditions that are treatable, but not clinically evident in the new-born period. Some of the conditions included in new-born 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.

New-born 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.

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.

There is a need to develop consistent nomenclature describing the type of data we want to capture about medications and their safety and effectiveness in neonates.