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Sudden Deaths and Apparent Life-Threatening Events in Hospitalized Neonates Presumed to Be Healthy

Sudden Deaths and Apparent Life-Threatening Events in Hospitalized Neonates Presumed to Be Healthy Abstract • We describe 10 apparently healthy newborns who were patients in a level 1 nursery and were found by caregivers to be limp, apneic, and requiring resuscitation. All patients were between ages 15 hours and 3½ days, products of term gestations, and of appropriate weight for gestational age. Prenatal or perinatal complications were present in nine of the 10 patients; in no patient was the complication considered a risk for serious, late-onset neonatal problems. All patients had been examined by a physician and were deemed to be in good health before the apparent lifethreatening event. Subsequent to the event, each patient required positive pressure ventilation and seven patients received chest compressions. Five patients died. Autopsies were performed on four of the five patients and in none was an adequate explanation for death established. Intrathoracic petechiae were found in one patient whose sibling had died of sudden infant death syndrome at age 11 weeks. Evaluation of the five survivors failed to determine a cause for the episodes. Of the five survivors, one had normal results of developmental examination at age 6 months, while the remaining four survivors had severe neurologic impairment at age 1 year. Apparent life-threatening events occur in hospitalized newborns presumed to be normal and may be a manifestation of early sudden infant death syndrome or early near-miss sudden infant death syndrome. (AJDC. 1991;145:1319-1322) References 1. Hunt CE, Brouillette RT. Sudden infant death syndrome: 1987 perspective . J Pediatr . 1987;110:669-677.Crossref 2. Mellins RB, Haddad GG. Sudden infant death syndrome . In: Behrman RE, Vaughan VC, Nelson WE, eds. Nelson Textbook of Pediatrics . Philadelphia, Pa: WB Saunders Co; 1987:1480-1482. 3. Beckwith JB. The Sudden Infant Death Syndrome . Rockville, Md; Public Health Service Office of Maternal and Child Health;1976. US Dept of Health, Education, and Welfare publication HSA 76-5137. 4. Brooks JG. Apnea of infancy and sudden infant death syndrome . AJDC . 1982;136:1012-1023. 5. Fedrick J. Sudden unexpected death in infants in the Oxford Record Linkage area: an analysis with respect to time and place . Br J Prev Soc Med . 1973;27:217-224. 6. Irgens LM, Skajaerven R, Peterson DR. Prospective assessment of recurrence risk in sudden infant death syndrome siblings . J Pediatr . 1984;104:349-351.Crossref 7. Biering-Sorenson F, Jorgensen T, Hilden J. J. Sudden infant death syndrome in Copenhagen 1956-1971, II: social factors and morbidity . Acta Paediatr Scand . 1979;68:1-9.Crossref 8. Naeye RL, Ladis B, Drage JS. Sudden infant death syndrome: a prospective study . AJDC . 1976;130:1207-1210. 9. Froggatt P, Lynas MA, Marshall TK. Sudden death in babies: epidemiology . Am J Cardiol . 1968;22:457-468.Crossref 10. Kraus JF, Borhani NO. Post-neonatal sudden unexplained death in California: a cohort story . Am J Epidemiol . 1972;95:497-510. 11. Peterson DR. Sudden, unexplained death in infants: an epidemiologic study . Am J Epidemiol . 1966;84:478-482. 12. Nelson KE, Greenberg MA, Mufson MA, Moses VK. The sudden infant death syndrome and epidemic viral disease . Am J Epidemiol . 1975;101:423-430. 13. Froggatt P, Lynas MA, MacKenzie G. Epidemiology of sudden unexpected death in infants ('cot death') in Northern Ireland . Br J Prev Soc Med . 1971;25:119-134. 14. Standfast SJ, Jereb S, Janerich DT. The epidemiology of sudden infant death in upstate New York . JAMA . 1979;241:1121-1124.Crossref 15. Polberger S, Svenningsen NW. Early neonatal sudden infant death and near death of full term infants in maternity wards . Acta Paediatr Scand . 1985;74:861-866.Crossref 16. Valdés-Dapena MA. Sudden and unexpected death in infancy: a review of the world literature 1954-1966 . Pediatrics . 1967;39:123-138. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Sudden Deaths and Apparent Life-Threatening Events in Hospitalized Neonates Presumed to Be Healthy

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Publisher
American Medical Association
Copyright
Copyright © 1991 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1991.02160110111033
Publisher site
See Article on Publisher Site

Abstract

Abstract • We describe 10 apparently healthy newborns who were patients in a level 1 nursery and were found by caregivers to be limp, apneic, and requiring resuscitation. All patients were between ages 15 hours and 3½ days, products of term gestations, and of appropriate weight for gestational age. Prenatal or perinatal complications were present in nine of the 10 patients; in no patient was the complication considered a risk for serious, late-onset neonatal problems. All patients had been examined by a physician and were deemed to be in good health before the apparent lifethreatening event. Subsequent to the event, each patient required positive pressure ventilation and seven patients received chest compressions. Five patients died. Autopsies were performed on four of the five patients and in none was an adequate explanation for death established. Intrathoracic petechiae were found in one patient whose sibling had died of sudden infant death syndrome at age 11 weeks. Evaluation of the five survivors failed to determine a cause for the episodes. Of the five survivors, one had normal results of developmental examination at age 6 months, while the remaining four survivors had severe neurologic impairment at age 1 year. Apparent life-threatening events occur in hospitalized newborns presumed to be normal and may be a manifestation of early sudden infant death syndrome or early near-miss sudden infant death syndrome. (AJDC. 1991;145:1319-1322) References 1. Hunt CE, Brouillette RT. Sudden infant death syndrome: 1987 perspective . J Pediatr . 1987;110:669-677.Crossref 2. Mellins RB, Haddad GG. Sudden infant death syndrome . In: Behrman RE, Vaughan VC, Nelson WE, eds. Nelson Textbook of Pediatrics . Philadelphia, Pa: WB Saunders Co; 1987:1480-1482. 3. Beckwith JB. The Sudden Infant Death Syndrome . Rockville, Md; Public Health Service Office of Maternal and Child Health;1976. US Dept of Health, Education, and Welfare publication HSA 76-5137. 4. Brooks JG. Apnea of infancy and sudden infant death syndrome . AJDC . 1982;136:1012-1023. 5. Fedrick J. Sudden unexpected death in infants in the Oxford Record Linkage area: an analysis with respect to time and place . Br J Prev Soc Med . 1973;27:217-224. 6. Irgens LM, Skajaerven R, Peterson DR. Prospective assessment of recurrence risk in sudden infant death syndrome siblings . J Pediatr . 1984;104:349-351.Crossref 7. Biering-Sorenson F, Jorgensen T, Hilden J. J. Sudden infant death syndrome in Copenhagen 1956-1971, II: social factors and morbidity . Acta Paediatr Scand . 1979;68:1-9.Crossref 8. Naeye RL, Ladis B, Drage JS. Sudden infant death syndrome: a prospective study . AJDC . 1976;130:1207-1210. 9. Froggatt P, Lynas MA, Marshall TK. Sudden death in babies: epidemiology . Am J Cardiol . 1968;22:457-468.Crossref 10. Kraus JF, Borhani NO. Post-neonatal sudden unexplained death in California: a cohort story . Am J Epidemiol . 1972;95:497-510. 11. Peterson DR. Sudden, unexplained death in infants: an epidemiologic study . Am J Epidemiol . 1966;84:478-482. 12. Nelson KE, Greenberg MA, Mufson MA, Moses VK. The sudden infant death syndrome and epidemic viral disease . Am J Epidemiol . 1975;101:423-430. 13. Froggatt P, Lynas MA, MacKenzie G. Epidemiology of sudden unexpected death in infants ('cot death') in Northern Ireland . Br J Prev Soc Med . 1971;25:119-134. 14. Standfast SJ, Jereb S, Janerich DT. The epidemiology of sudden infant death in upstate New York . JAMA . 1979;241:1121-1124.Crossref 15. Polberger S, Svenningsen NW. Early neonatal sudden infant death and near death of full term infants in maternity wards . Acta Paediatr Scand . 1985;74:861-866.Crossref 16. Valdés-Dapena MA. Sudden and unexpected death in infancy: a review of the world literature 1954-1966 . Pediatrics . 1967;39:123-138.

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Nov 1, 1991

References