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Very early neonatal apparent life-threatening events and sudden unexpected deaths: incidence and risk factors.

Dageville C, Pignol J, De Smet S

Neonatal Intensive Care Unit, University Hospital, Nice, France. dageville.chu-nice.fr

AIM: To evaluate the incidence of neonatal apparent life-threatening events and sudden unexpected deaths during the first 2 h after birth. METHODS: A prospective study was conducted over a 1-year period in all the maternities of the French region of Provence, Alpes, Côte d'Azur, which included all presumably healthy full-term neonates. Twenty-three previously published cases were also studied in order to identify possible risk factors. RESULTS: Sixty two thousand nine hundred sixty-eight live births were recorded over the study period. There were two neonatal apparent life-threatening events and no neonatal sudden unexpected death. The overall rate of neonatal apparent life-threatening events and unexpected deaths was thus 0.032 per 1000 live births. Three potential risk factors were identified: skin-to-skin contact, primiparous mother and mother and baby alone in the delivery room. CONCLUSION: A neonatal apparent life-threatening event or sudden unexpected death during the first 2 h of life is very uncommon. Skin-to-skin contact between mother and infant left alone in the delivery room may constitute the main risk situation. This must not lead to reconsider skin-to-skin contact that has been proven beneficial and seems per se almost safe, but must induce maternity staff to pay particular attention to a skin-to skin infant when left alone with its mother.

Published 5 June 2008 in Acta Paediatr, 97(7): 866-9.
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