CAQ-Peds key terms

A stepwise approach to the newborn who does not breathe or has low tone at birth: warm, dry, stimulate, position the airway, and give positive pressure ventilation if apnea or heart rate below 100 persists.

Assisted breaths given to a newborn with apnea, gasping, or a heart rate under 100 beats per minute, typically with a self-inflating bag or T-piece device and a face mask, and the most effective single step in neonatal resuscitation.

Fetal stool passed into the amniotic fluid before delivery, which signals possible fetal distress; routine intubation and suctioning of the vigorous infant is no longer recommended, but nonvigorous infants may need airway clearance.

Delivery of a steady distending pressure through nasal prongs to keep small airways and alveoli open, used for respiratory distress syndrome and apnea of prematurity to reduce the work of breathing without intubation.

Instillation of exogenous surfactant into the trachea of a premature infant with respiratory distress syndrome to lower alveolar surface tension, improve lung compliance, and reduce the risk of pneumothorax and death.

Breathing difficulty in premature infants caused by surfactant deficiency, producing grunting, retractions, tachypnea, and low oxygen levels soon after birth, with a chest radiograph showing low lung volumes and a ground-glass pattern.

Pauses in breathing lasting 20 seconds or more, or shorter pauses with bradycardia or desaturation, in an infant born before about 37 weeks due to an immature respiratory control center; treated with caffeine citrate.

A methylxanthine given to premature infants to stimulate the respiratory center, reduce apnea and bradycardia episodes, and shorten the need for mechanical ventilation; loading and maintenance doses are weight based.

Yellow discoloration of skin and sclera from elevated unconjugated bilirubin, common in the first week of life; timing, rate of rise, and risk factors determine whether it is physiologic or requires phototherapy or further evaluation.

Exposure of an infant's skin to blue-green light that converts bilirubin into water-soluble isomers excreted without conjugation, lowering serum levels; intensity, distance, and exposed surface area determine effectiveness.

Permanent neurologic injury from bilirubin deposition in the basal ganglia and brainstem, causing choreoathetoid cerebral palsy, hearing loss, and upward gaze palsy; prevention depends on timely treatment of severe hyperbilirubinemia.

A blood test that detects antibodies bound to an infant's red cells, helping identify immune-mediated hemolysis such as ABO or Rh incompatibility as a cause of early jaundice or anemia.

Destruction of fetal red cells by maternal antibodies crossing the placenta, most often anti-RhD, producing anemia, jaundice, and sometimes hydrops; prevented by giving anti-D immune globulin to Rh-negative mothers.

A withdrawal syndrome in newborns exposed prenatally to opioids or other substances, marked by irritability, tremors, poor feeding, diarrhea, and autonomic signs; managed with supportive care and sometimes pharmacologic treatment.

A standardized checklist that quantifies withdrawal signs in newborns, including crying, tone, tremors, feeding, and vital signs; serial scores guide whether drug therapy is started or adjusted.

A newborn whose birth weight is below the 10th percentile for gestational age, which raises risk of hypoglycemia, hypothermia, polycythemia, and meconium aspiration and warrants close monitoring after birth.

Failure of a fetus to reach expected growth because of placental insufficiency, maternal disease, infection, or chromosomal abnormality; affected infants are at risk for perinatal asphyxia and long-term growth and developmental problems.

Low blood glucose in a newborn, often defined as below 45 mg/dL in the first days, causing jitteriness, lethargy, or poor feeding; infants of diabetic mothers and growth-restricted infants are at highest risk.

A newborn exposed to maternal hyperglycemia in utero, leading to fetal hyperinsulinism and increased risk of macrosomia, birth trauma, hypoglycemia, polycythemia, and respiratory distress after delivery.

The sudden death of an infant under one year that remains unexplained after investigation; risk is reduced by supine sleeping, a firm flat surface, room sharing without bed sharing, and avoiding overheating and smoke exposure.

Infant sleep practices that lower suffocation and death risk: placing the baby on the back on a firm mattress with no loose bedding, pillows, or bumpers, and keeping the sleep area free of soft objects.

A sudden, brief episode in an infant under one year of cyanosis, pallor, breathing change, or altered responsiveness that resolves completely; management depends on history and exam findings rather than automatic testing.

An older label for a frightening infant event combining apnea, color change, and altered tone; replaced by brief resolved unexplained event because the term implied risk that the clinical picture did not reliably predict.

State-mandated testing of dried blood spots shortly after birth for treatable congenital disorders such as hypothyroidism, phenylketonuria, hemoglobinopathies, and cystic fibrosis, plus hearing and critical congenital heart disease screening.

Inadequate thyroid hormone production present at birth, often from thyroid dysgenesis; infants appear normal initially, so detection by newborn screening and early levothyroxine treatment are essential to prevent intellectual disability.

Pulse oximetry measured in the right hand and one foot before newborn discharge to detect ductal-dependent heart lesions; a low or discrepant saturation prompts prompt echocardiography and evaluation.

A structural heart defect in which survival depends on a patent ductus arteriosus for mixing or systemic blood flow, such as transposition of the great arteries or severe coarctation; prostaglandin E1 keeps it open.

A continuous intravenous medication that keeps the ductus arteriosus open in newborns with ductal-dependent heart lesions, buying time before surgery; apnea and fever are common adverse effects requiring monitoring.

Skin-to-skin contact between a newborn and caregiver with breastfeeding support, shown to improve thermoregulation, feeding, and survival in low-birth-weight infants and to strengthen bonding.

The newborn's limited ability to conserve heat because of a high surface-area-to-mass ratio and immature shivering; cold stress increases oxygen consumption and glucose use, so warming and drying are priorities.

Keeping the cord stump clean and dry and allowing it to separate naturally; signs of infection such as redness, purulent drainage, or foul odor require prompt evaluation for omphalitis.

A systemic infection in the first 72 hours of life, often from group B streptococcus or Escherichia coli acquired during delivery, presenting with temperature instability, respiratory distress, and poor feeding; treated empirically with antibiotics.

Infection appearing after the first week of life, usually from organisms acquired in the hospital or community such as coagulase-negative staphylococci, and often associated with central lines and prolonged hospitalization.

Intrapartum intravenous penicillin or ampicillin given to laboring women who are colonized with group B streptococcus or have other risk factors, reducing early-onset neonatal infection.

Chronic lung disease of prematurity defined by continued oxygen need at 36 weeks postmenstrual age, resulting from lung injury and arrested alveolar development; prevention includes gentle ventilation and avoiding excess fluid.

Abnormal blood vessel growth in the retina of premature infants exposed to supplemental oxygen and fluctuating oxygen levels, which can progress to retinal detachment; staged screening exams guide laser or injection treatment.

Inflammation and necrosis of the premature infant's bowel, presenting with feeding intolerance, abdominal distention, bloody stools, and lethargy; management includes stopping feeds, decompressing the gut, and antibiotics.