Sudden Unexpected Postnatal Collapse Resulting in Newborn Death in the United States

Abstract

Background: The sudden collapse of an apparently healthy newborn, or sudden unexpected postnatal collapse (SUPC) is fatal in about half of cases. Epidemiological characteristics of sudden unexpected infant death (SUID) in the fi rst week of life differ from those in the postperinatal age group (7-365 days). Aim: To describe the characteristics of SUPC resulting in neonatal death. Methods: We analyzed the Centers for Disease Control and Prevention Birth Cohort Linked Birth/Infant Death Data Set (2003-2013: 41,125,233 births and 37,624 SUIDs). SUPC was defi ned as infants born ≥35 weeks gestational age, with a 5-minute Apgar score of ≥7, who died suddenly and unexpectedly in the fi rst week of life. Results: Of the 37,624 deaths categorized as SUID during the study period, 616 met the SUPC criteria (1.5/100,000 live births). Eleven percent occurred on the fi rst day of life and nearly three quarters occurred during postnatal days 3-6. SUPC deaths differed statistically from SUID deaths occurring 7-364 days of age, in particular for sex, marital status, and live birth order. Implications: These data support the need for adequate nurse staffi ng during the immediate recovery period and for the entire postpartum stay as well as nurse rounding for new mothers in the hospital setting.

Safe Newborn Sleep Practices on a Large Volume Maternity Service

“…Sudden unexpected infant death includes accidental suffocations, sudden infant death syndrome (SIDS), and other unknown causes. Although some cases of SUID occur during the childbirth hospitalization, most occur at home after hospital discharge (Anderson et al, 2021). The United States Department of Health and Human Services created the “Back to Sleep” campaign in 1994 to educate the public and new parents on safe sleeping recommendations to reduce the risk of SIDS.…”

Infant Safe Sleep Initiative in a Small Volume Maternity Service

“…Sudden unexpected infant death (SUID) is an umbrella diagnosis defined as any infant death that is unexpected and occurs within the first year of life, despite a known or unknown etiology (American Academy of Pediatrics [AAP] Task Force on Sudden Infant Death Syndrome et al, 2016; Anderson et al, 2021; Caraballo et al, 2016; Sleutel et al, 2018). Sudden infant death syndrome (SIDS) falls under the SUID umbrella, defined as unexplained, unexpected infant death occurring in infants less than 1 year of age (Centers for Disease Control and Prevention [CDC], 2018).…”

“…Items such as using wearable blankets (sleep sacks), room sharing without cosleeping, avoiding thick or fluffy blankets, and placing infant on a firm, flat mattress all comprise the backbone of the recommendations (AAP Task Force on Sudden Infant Death Syndrome et al, 2016; Feldman-Winter et al, 2016). Other items such as recommending breastfeeding; avoiding tobacco, alcohol, and drug use in the home; and the use of pacifiers supplement the ABCs of safe sleep to ensure a comprehensive safe sleeping environment for infants (AAP Task Force on Sudden Infant Death Syndrome et al, 2016; Anderson et al, 2021; Feldman-Winter et al, 2016). Recommendations focusing on safe infant sleep in the hospital include continuous observation of the newborn by the nurse during the first 2 hours after birth, positioning and observation during skin-to-skin care, recommendations for rooming in, and frequent rounding on mother–baby couplets during postpartum (Feldman-Winter et al, 2016; The Joint Commission, 2018).…”

“…Sudden Infant Death Syndrome et al, 2016;Anderson et al, 2021;Feldman-Winter et al, 2016). Recommendations focusing on safe infant sleep in the hospital include continuous observation of the newborn by the nurse during the first 2 hours after birth, positioning and observation during skin-to-skin care, recommendations for rooming in, and frequent rounding on mother-baby couplets during postpartum (Feldman-Winter et al, 2016;The Joint Commission, 2018).…”

“…Parents following the guidelines at home is strongly associated with safe sleep environment modeling by nurses while the infant is in the hospital after birth (Caraballo et al, 2016;Sleutel et al, 2018;Whiteside-Mansell et al, 2017). Lack of following the safe sleep practices in the hospital S udden unexpected infant death (SUID) is an umbrella diagnosis defined as any infant death that is unexpected and occurs within the first year of life, despite a known or unknown etiology (American Academy of Pediatrics [AAP] Task Force on Sudden Infant Death Syndrome et al, 2016;Anderson et al, 2021;Caraballo et al, 2016;Sleutel et al, 2018). Sudden infant death syndrome (SIDS) falls under the SUID umbrella, defined as unexplained, unexpected infant death occurring in infants less than 1 year of age (Centers for Disease Control and Prevention [CDC], 2018).…”