Unexpected Collapse of Healthy Newborn Infants: Risk Factors, Supervision and Hypothermia Treatment

Overview

Journal Acta Paediatr

Specialty Pediatrics

Date 2013 Apr 5

PMID 23551812

Citations 19

Authors

Nicolas J Pejovic

Eric Herlenius

Affiliations

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Abstract

Aim: To determine the occurrence and risk factors of sudden unexpected postnatal collapse (SUPC) in presumably healthy newborn infants.

Methods: All live-born infants during a 30-month period, in five major delivery wards in Stockholm, were screened, and possible cases of SUPC thoroughly investigated. Infants were ≥35 weeks of gestation, had an Apgar score >8 at 10 min and collapsed within 24 h after birth. Maternal, infant, event characteristics and outcome data were collected.

Results: Twenty-six cases of SUPC were found among 68 364 live-born infants, an incidence of 38/100 000 live births. Sixteen of these cases of SUPC required resuscitation with ventilation >1 min, and 14 of these remained unexplained (21/100 000). Fifteen of the 26 children were found in a prone position, during skin-to-skin contact, 18 were primipara, and 13 occurred during unsupervised breastfeeding at <2 h of age. Three cases occurred during smart cellular phone use by the mother. Five developed hypoxic-ischaemic encephalopathy (HIE) grade 2, and 4 underwent hypothermia treatment. Twenty-five infants had a favourable neurological outcome.

Conclusion: SUPC in apparent healthy babies is associated with initial, unsupervised breastfeeding, prone position, primiparity and distractions. Guidelines outlining the appropriate monitoring of newborns and safe early skin-to-skin contact should be implemented.

Citing Articles

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References

Andres V, Garcia P, Rimet Y, Nicaise C, Simeoni U . Apparent life-threatening events in presumably healthy newborns during early skin-to-skin contact. Pediatrics. 2011; 127(4):e1073-6. DOI: 10.1542/peds.2009-3095. View

Herlenius E . An inflammatory pathway to apnea and autonomic dysregulation. Respir Physiol Neurobiol. 2011; 178(3):449-57. DOI: 10.1016/j.resp.2011.06.026. View

Moore E, Anderson G, Bergman N, Dowswell T . Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database Syst Rev. 2012; (5):CD003519. PMC: 3979156. DOI: 10.1002/14651858.CD003519.pub3. View

Gatti H, Castel C, Andrini P, Durand P, Carlus C, Chabernaud J . [Cardiorespiratory arrest in full term newborn infants: six case reports]. Arch Pediatr. 2004; 11(5):432-5. DOI: 10.1016/j.arcped.2004.02.012. View

Melchor J, Linares A, Aranguren G, Quintanilla M, Fernandez-Llebrez L, de la Gandara A . Early neonatal sudden death or near death syndrome. An epidemiological study of 29 cases. Acta Paediatr. 1994; 83(7):704-8. DOI: 10.1111/j.1651-2227.1994.tb13123.x. View

Lagercrantz H, Slotkin T . The "stress" of being born. Sci Am. 1986; 254(4):100-7. DOI: 10.1038/scientificamerican0486-100. View

Foran A, Cinnante C, Groves A, Azzopardi D, Rutherford M, Cowan F . Patterns of brain injury and outcome in term neonates presenting with postnatal collapse. Arch Dis Child Fetal Neonatal Ed. 2008; 94(3):F168-77. DOI: 10.1136/adc.2008.140301. View

Poets A, Steinfeldt R, Poets C . Sudden deaths and severe apparent life-threatening events in term infants within 24 hours of birth. Pediatrics. 2011; 127(4):e869-73. DOI: 10.1542/peds.2010-2189. View

Grylack L, Williams A . Apparent life-threatening events in presumed healthy neonates during the first three days of life. Pediatrics. 1996; 97(3):349-51. View

10.

Hays S, Feit P, Barre P, Cottin X, Huin N, Fichtner C . [Respiratory arrest in the delivery room while lying in the prone position on the mothers' chest in 11 full term healthy neonates]. Arch Pediatr. 2006; 13(7):1067-8. DOI: 10.1016/j.arcped.2006.03.006. View

11.

Livesey A . A multiagency protocol for responding to sudden unexpected death in infancy: descriptive study. BMJ. 2004; 330(7485):227-8. PMC: 546068. DOI: 10.1136/bmj.38323.652523.F7. View

12.

Inwald D, Franklin O, Cubitt D, Peters M, Goldman A, Burch M . Enterovirus myocarditis as a cause of neonatal collapse. Arch Dis Child Fetal Neonatal Ed. 2004; 89(5):F461-2. PMC: 1721738. DOI: 10.1136/adc.2003.034439. View

13.

Moon R . SIDS and other sleep-related infant deaths: expansion of recommendations for a safe infant sleeping environment. Pediatrics. 2011; 128(5):e1341-67. DOI: 10.1542/peds.2011-2285. View

14.

Becher J, Bhushan S, Lyon A . Unexpected collapse in apparently healthy newborns--a prospective national study of a missing cohort of neonatal deaths and near-death events. Arch Dis Child Fetal Neonatal Ed. 2011; 97(1):F30-4. DOI: 10.1136/adc.2010.208736. View

15.

Olsson E, Andersen R, Axelin A, Jonsdottir R, Maastrup R, Eriksson M . Skin-to-skin care in neonatal intensive care units in the Nordic countries: a survey of attitudes and practices. Acta Paediatr. 2012; 101(11):1140-6. DOI: 10.1111/j.1651-2227.2012.02802.x. View

16.

Fleming P . Unexpected collapse of apparently healthy newborn infants: the benefits and potential risks of skin-to-skin contact. Arch Dis Child Fetal Neonatal Ed. 2011; 97(1):F2-3. DOI: 10.1136/archdischild-2011-300786. View

17.

Herlenius E, Kuhn P . Sudden unexpected postnatal collapse of newborn infants: a review of cases, definitions, risks, and preventive measures. Transl Stroke Res. 2013; 4(2):236-47. PMC: 3599160. DOI: 10.1007/s12975-013-0255-4. View

18.

Peters C, Becher J, Lyon A, Midgley P . Who is blaming the baby?. Arch Dis Child Fetal Neonatal Ed. 2009; 94(5):F377-8. DOI: 10.1136/adc.2008.143628. View

19.

Poets A, Urschitz M, Steinfeldt R, Poets C . Risk factors for early sudden deaths and severe apparent life-threatening events. Arch Dis Child Fetal Neonatal Ed. 2012; 97(6):F395-7. DOI: 10.1136/archdischild-2011-300752. View

20.

Cordero Jr L, Hon E . Neonatal bradycardia following nasopharyngeal stimulation. J Pediatr. 1971; 78(3):441-7. DOI: 10.1016/s0022-3476(71)80224-x. View