Lung Maturation: The Survival Miracle of Very Low Birth Weight Infants

The increased survival of very preterm infants is generally attributed to improved care strategies. This review develops the thesis that the features of abnormal pregnancies responsible for very preterm deliveries also provide an explanation of why very preterm infants often survive. A normal fetus...

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Main Author: Alan H. Jobe
Format: Article
Language:English
Published: Elsevier 2010-02-01
Series:Pediatrics and Neonatology
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S1875957210600034
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author Alan H. Jobe
author_facet Alan H. Jobe
author_sort Alan H. Jobe
collection DOAJ
description The increased survival of very preterm infants is generally attributed to improved care strategies. This review develops the thesis that the features of abnormal pregnancies responsible for very preterm deliveries also provide an explanation of why very preterm infants often survive. A normal fetus born at 24 weeks is very unlikely to survive. However, pregnancies that result in deliveries at 24 weeks are generally highly abnormal, and may have been so for prolonged periods prior to the preterm deliveries. Inflammatory or vascular developmental abnormalities resulting in very preterm birth can alter fetal development in such a way that organ system maturation is induced. This is supported clinically by the relative lack of very preterm infants with respiratory distress syndrome. Interventions such as antenatal corticosteroid treatment and postnatal surfactant treatment for infants with respiratory distress syndrome and gentle ventilation strategies maximize fetal adaptations to the abnormal fetal environment and improve outcomes.
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spelling doaj.art-0812ce9da74a4d2c8bba3bb9c66d11aa2022-12-21T23:29:26ZengElsevierPediatrics and Neonatology1875-95722010-02-0151171310.1016/S1875-9572(10)60003-4Lung Maturation: The Survival Miracle of Very Low Birth Weight InfantsAlan H. JobeThe increased survival of very preterm infants is generally attributed to improved care strategies. This review develops the thesis that the features of abnormal pregnancies responsible for very preterm deliveries also provide an explanation of why very preterm infants often survive. A normal fetus born at 24 weeks is very unlikely to survive. However, pregnancies that result in deliveries at 24 weeks are generally highly abnormal, and may have been so for prolonged periods prior to the preterm deliveries. Inflammatory or vascular developmental abnormalities resulting in very preterm birth can alter fetal development in such a way that organ system maturation is induced. This is supported clinically by the relative lack of very preterm infants with respiratory distress syndrome. Interventions such as antenatal corticosteroid treatment and postnatal surfactant treatment for infants with respiratory distress syndrome and gentle ventilation strategies maximize fetal adaptations to the abnormal fetal environment and improve outcomes.http://www.sciencedirect.com/science/article/pii/S1875957210600034lung maturationprematurityprenatal corticosteroidsrespiratory distress syndromesurfactant
spellingShingle Alan H. Jobe
Lung Maturation: The Survival Miracle of Very Low Birth Weight Infants
Pediatrics and Neonatology
lung maturation
prematurity
prenatal corticosteroids
respiratory distress syndrome
surfactant
title Lung Maturation: The Survival Miracle of Very Low Birth Weight Infants
title_full Lung Maturation: The Survival Miracle of Very Low Birth Weight Infants
title_fullStr Lung Maturation: The Survival Miracle of Very Low Birth Weight Infants
title_full_unstemmed Lung Maturation: The Survival Miracle of Very Low Birth Weight Infants
title_short Lung Maturation: The Survival Miracle of Very Low Birth Weight Infants
title_sort lung maturation the survival miracle of very low birth weight infants
topic lung maturation
prematurity
prenatal corticosteroids
respiratory distress syndrome
surfactant
url http://www.sciencedirect.com/science/article/pii/S1875957210600034
work_keys_str_mv AT alanhjobe lungmaturationthesurvivalmiracleofverylowbirthweightinfants