APPSPGHAN 2022

Azanna Ahmad Kamar

Malaysia

Dr. Azanna Ahmad Kamar is an Associate Professor and Consultant Neonatologist at the Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. She trained in Paediatrics at the Paediatric Institute, Hospital Kuala Lumpur, and in the Republic of Ireland, where she worked at the Rotunda Hospital, Our Lady’s Hospital for Sick Children Crumlin, and the Coombe Women and Infants’ University Hospital. She is currently the head of the Neonatal Intensive Care Unit (NICU) the of University of Malaya Medical Centre (UMMC).

Her main interests include paediatric bioethics, infection control, ventilation, medical education, infant nutrition, neonatal transport & resources, quality improvement initiatives, systematic reviews, and neonatal innovations. She completed her certification in Paediatric Bioethics from Children’s Mercy Hospital, University of Missouri, Kansas City, USA in 2016, and teaches the Special Population course of Masters of Health in Research Ethics (MOHRE). Specific bioethics interests include neonatal end-of-life issues, medical innovations & their impact, technology dependence, shared-decisions, and sociocultural influences in decision making.

She is also the past President of the Perinatal Society of Malaysia (Council 2016/2017) and a current council member; a member of the Malaysian Bioethics Community (MBC) and Clinical Ethics Malaysia (CEM); a writing team member of the South East Asia Early Nutrition Academy (ENEA-SEA) e-learning infant nutrition platform under EU-Erasmus e-learning collaboration; the head of the Research and Publications committee of the Federation of Asia-Oceania Perinatal Societies (FAOPS); a steering committee member of the Malaysian National Neonatal Registry (MNNR); chairperson of the scientific committee of the FAOPS 2022 congress; a champion of the Malaysian Prematurity Awareness Programme; and was a past Organising/ Scientific Chair of the Kuala Lumpur International Neonatology Conference (KLINC).

The First 1000 Days: Challenges of The Preterm Infant

Nutrition Symposium: Breastfeeding and complementary feeding

13 October 2022 (1600-1730) @ Sipadan Hall 3

The increasing prevalence of babies born preterm, especially those delivered at lower gestations, has caused significant neonatal management challenges to ensure their optimal long-term outcomes with an appropriately high health-related quality of life. Infants delivered preterm face unique challenges from the time that they are within the confines of the mother’s womb. The first 1000 days refers to the period most vulnerable to epigenetic modification or trauma, from the period of conception, right through to the embryonic, perinatal period, and subsequent lactation period, up until the infant reaches the age of 2 years. The initial adverse intrauterine exposure that predisposes preterm delivery, for example, chronic intrauterine hypoxia secondary to placental insufficiency may continue to exert significant effects on the physiologically immature infant until adulthood. The challenges faced during the preterm infant’s first 1000 days would therefore result in conditions unique to preterm infants who experience an initial nutrition phenomenon of failure to meet nutritional demands whilst being physiologically immature, within a hostile ex-utero environment that fails to support the period for occurrence of the most rapid neurodevelopmental growth. The difficulty in meeting these nutritional challenges can further worsen the medical outcomes of preterm infants. The morbidities associated with preterm delivery such as bronchopulmonary dysplasia, retinopathy of prematurity, and periventricular leukomalacia may further adversely affect the preterm infant’s gut microbiota, affecting their long-term growth and neurodevelopmental outcomes, including affecting their future risks of developing non-communicable diseases. This talk provides an overview of the evidence and research surrounding these challenges and summarises the support required for the period of the first 1000 days of the preterm infant to ensure their optimal outcomes, i.e., from the intrauterine period that the infant is determined to be at risk of fetal compromise, up until the age of 2 years.

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