How to Be Cautious About Four Critical Conditions in Newborns?

How to Be Cautious About Four Critical Conditions in Newborns?

Newborns have underdeveloped organs and low immunity, making them vulnerable to infections or organic damage. Parents must be aware of common diseases that newborns are susceptible to in order to detect and treat them early. Here, we introduce four common critical conditions in newborns, hoping to raise awareness.

(1) Neonatal Pneumonia

Neonatal pneumonia can be classified into aspiration pneumonia and infectious pneumonia based on different causes. Aspiration pneumonia occurs when an infant inhales certain substances during prenatal, perinatal, or postnatal periods, such as meconium, amniotic fluid, or breast milk. Infectious pneumonia, on the other hand, results from various pathogenic microorganisms (including bacteria and viruses) infecting the newborn during intrauterine, perinatal, or postnatal periods.

Severe neonatal pneumonia, whether aspiration or infectious, can lead to complications such as respiratory failure and heart failure, and may even require specialized treatments like mechanical ventilation. Parents should pay sufficient attention to this condition, carefully monitor their child's health, and cooperate actively with medical treatment.

Neonatal pneumonia has a relatively high incidence and mortality rate. In the early stages, affected infants may only exhibit reduced or no appetite, restlessness, low body temperature, or failure to maintain body temperature. As the condition progresses, more typical symptoms like rapid breathing (＞60 times per minute), foaming at the mouth, and cyanosis around the mouth may appear. In such cases, immediate hospitalization and treatment are essential.

(2) Neonatal Sepsis

Neonatal sepsis refers to a systemic infection in newborns caused by pathogenic bacteria entering the bloodstream through various pathways. It is one of the common critical conditions in the neonatal period, with an incidence rate ranging from 1‰ to 10‰ among live births, and higher in preterm infants.

Main symptoms include poor appetite, low spirits, fever (preterm infants or severe cases may exhibit decreased body temperature), followed by pale or grayish complexion, drowsiness, worsening jaundice, presence of bleeding spots on the body, abdominal distension, and enlargement of the liver and spleen.

(3) Hypoxic-Ischemic Encephalopathy (HIE)

HIE in newborns refers to brain damage caused by various factors leading to hypoxia and decreased cerebral blood flow. It primarily manifests as edema, softening, necrosis, and hemorrhage of brain tissue, which is an important complication of neonatal asphyxia. It can result in neurological disabilities in children, such as cerebral palsy, intellectual disabilities, epilepsy, deafness, and visual impairment.

HIE can be classified into three degrees based on severity: ① Mild: characterized by excessive alertness, irritability, excitement, and high excitement (tremors and twitching), without seizures. Symptoms often resolve gradually within 3 days, with a good prognosis. ② Moderate: characterized by decreased crying and movement, somnolence or shallow coma, transient apnea, and decreased muscle tone. Fifty percent of cases may have seizures, and if symptoms persist for 7 to 10 days, there may be sequelae. ③ Severe: infants are in a coma state with extremely low muscle tone, limpness, absence of embracing reflexes and tendon reflexes, unequal-sized pupils, poor response to light, bulging fontanelle, frequent seizures, irregular or stopped breathing, and even respiratory failure. Severe cases have a high mortality rate, and survivors often suffer from sequelae.

(4) Purulent Meningitis in Newborns

Purulent meningitis in newborns refers to the inflammation of the meninges caused by pyogenic bacteria, often secondary to sepsis. Clinical symptoms are usually atypical (especially in preterm infants) and include pale or purplish complexion, poor feeding, poor responses, failure to maintain body temperature or fever, weak crying or screaming, staring, and a bulging fontanelle. Severe cases may experience seizures. Symptoms may resemble those of HIE and sepsis and are often present together with sepsis. Therefore, when purulent meningitis is suspected, early examination of cerebrospinal fluid, early diagnosis, and timely treatment are crucial to reduce mortality and sequelae.