All About The Neonatal Period, Risks, Precautions & Points To Remember

Medically reviewed by Maria Sarino, MD FACT CHECKED

Being one of the most crucial phases in a human’s life, the neonatal period occurs in the first four weeks of an infant. It is a transitional period during which the newborn adapts to the new life outside the womb. During this transitional period, the infant may observe several changes, especially in the respiratory and cardiovascular systems.

The infant even develops different patterns of infancy like bonding and feeding during the neonatal phase. Now let us delineate in detail about the neonatal period, different developments associated with it, its risks, precautions, and other points to remember!

As mentioned earlier, the neonatal period includes the initial four weeks of an infant. Several physiological changes occur in the infant’s body during this phase due to the loss of the low-pressure placenta. Once the placenta is lost, different activities like the gas change, circulation, and waste management of the fetus tend to find other physiological adaptations.

However, sometimes the physiological adaptations and developments might even lead to an enhanced risk for post-birth complications or other birth defects and congenital conditions. On the other hand, if there is premature birth, then it could even lead to several complications in the physiological changes and development of the infant.

Data For The Neonates

The neonatal period even includes the perinatal period, which is the initial phase after birth. During this phase, the normal blood volume of an infant may range anywhere between 85 to 95ml per kg. Moreover, the average total body water percentage of the infant might be 70% and normal glucose may be greater than 40MG per dl.

Physiological Changes During The Neonatal Period

Once the umbilical cord is separated and the baby takes the first breath, the oxygen tension in the arteries augments. On the other hand, pulmonary vascular resistance truncates at the same time, thus, enhancing the gas exchange in the lungs. Due to all this, the left atrial pressure increases and the right atrial pressure decreases. Hence, changes in all such factors might lead to physiological development in the newborn.

Additionally, the lung surfactants may even play a crucial role in determining the development of the lungs on delivery. Once the cortisol is released through the hypothalamus, It could lead to the maturation of the neonate’s lung. However, in the case of preterm birth, the Lungs may not mature and it could result in certain complications and risks in the neonate. Now let’s have a glance at the different risks and complications related to the neonatal phase.

Risks And Complications

According to a study conducted in 2019, approximately 2.4 million infants died globally in the first month of their birth.

Though the death rates during the neonatal period have slightly decreased in the past few decades, the complications and risks related to the pregnancy and delivery during the neonatal are still high.

The reason behind this is because approximately 75% of infant deaths occur during the initial first week of their birth.

On the other hand, if you take regular prenatal care and adopt several precautions, then it might even help you to identify some of the complications even before delivery.

In such situations, the medical teams and the doctors may identify the child as “high risk” and get enough time to take care of the infant during delivery with the right tools.

Not only this, but the healthcare providers might even observe the infant after birth to identify any illnesses or complications. Some of the possible complications or risks that could come up during the delivery process and neonatal period are as follows-

  • Low blood sugar.
  • Birth defects or infections
  • Delay in development
  • Low weight during birth
  • Seizures or cerebral palsy
  • Jaundice
  • Issues related to temperature control.
  • Difficulties in feeding
  • Hearing and vision issues
  • Delay in the development of the infant
  • Breathing problems

Some of the infants who require extensive care may even be admitted to the neonatal intensive care unit just after birth.

However, in case there are no complications or risks, then the healthcare team might transfer the baby to the post-Natal care unit after delivery.

In the United States, the hospitals may even have at least a 48-hour hospital stay rule after birth through vaginal delivery or a 96-hour hospital stay after birth by Caesarean delivery.

Other Complications

Changes In The Digestive And Excretory System During The Neonatal Period

 As mentioned earlier, nutrition was provided to the fetus through the placenta before birth. However, once the infant is born, all such systems, including the digestive and excretory systems, develop and function on their own.

Initially, when the excretory system starts functioning, it excretes  Meconium. Meconium is a substance that is accumulated in the digestive system and includes a whisk of epithelial cells, mucus, and bile.

However, sometimes the meconium might be excreted either during delivery or before it. In such cases, the meconium could be a reason for the dispersal of the infection in the fetus.

Gradually the excretory system begins functioning normally as it filters the blood from the kidneys.

However, this is the phase when the excretory system is learning to function. Due to this, it might lead to a higher amount of water loss because the kidneys may try to concentrate the urine. Hence it is crucial to keep the neonates hydrated during this phase.

More on the neonatal gastronomical system here.

All About The Neonatal Period

Here are certain points to remember regarding the neonatal period and birth-

  • Under stressful circumstances, the risks of the neonates for bradycardic episodes augments. Pointers for its management are discussed here.
  • The neonates have an immature blood-brain barrier and relatively small airway anatomy.
  • During the neonatal period, the infants may even be more susceptible to respiratory fatigue. Governmental paper here.
  • Due to truncated ventricular compliance, the heart of the infants during their neonatal phase depends on the heart rate for the overall cardiac result.
  • The narrowest portion of the airway in infants during their neonatal phase is the subglottic area.
  • During the neonatal phase, the infants have an increased risk of hypothermia. More on the same here.
  • The immature liver of the neonates can even increase their susceptibility towards coagulopathies, hyperbilirubinemia, and hypoglycemia.

Sometimes the efficiency of the medications consumed by the neonates might be reduced. The primary reason behind this could be augmentation in TBW, which may lead to dilution.

Let Us Wrap It Up!

Thus, you may always concoct a follow-up care plan before delivering your baby.

It could help you to prepare in advance for the different tests and screenings your baby might undergo. These tests and screenings help to identify different hearing problems, diseases, and other such precautions and risks in your infant.

The baby might even be given several vaccinations during the neonatal phase to avert any diseases. So you may select your pediatrician before your delivery to reduce the risks of the neonatal period.

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