Unexpected collapse of healthy newborn infants: risk factors, supervision and hypothermia treatment
Article first published online: 30 APR 2013
©2013 Foundation Acta Pædiatrica. Published by John Wiley & Sons Ltd
Volume 102, Issue 7, pages 680–688, July 2013
How to Cite
Pejovic, N. J. and Herlenius, E. (2013), Unexpected collapse of healthy newborn infants: risk factors, supervision and hypothermia treatment. Acta Paediatrica, 102: 680–688. doi: 10.1111/apa.12244
- Issue published online: 30 MAY 2013
- Article first published online: 30 APR 2013
- Accepted manuscript online: 28 MAR 2013 11:30AM EST
- Manuscript Revised: 19 MAR 2013
- Manuscript Accepted: 19 MAR 2013
- Manuscript Received: 10 OCT 2012
- Cellular phone;
- Severe ALTE;
- Skin-to-skin care;
- Sudden unexpected postnatal collapse
To determine the occurrence and risk factors of sudden unexpected postnatal collapse (SUPC) in presumably healthy newborn infants.
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.
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.
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.