Department of Neonatology, Tuebingen University Hospital, Calwerstr. 7, 72076 Tuebingen, Germany.
Arch Dis Child Fetal Neonatal Ed. 2012 Nov;97(6):F395-7. doi: 10.1136/archdischild-2011-300752. Epub 2012 Jan 31.
To identify potential risk factors for unexpected sudden infant deaths (SID) and severe apparent life-threatening events (S-ALTE) within 24 h of birth.
Case-control study embedded in an epidemiological survey over a 2-year period.
Throughout 2009, every paediatric department in Germany was asked to report cases of unexplained SID or S-ALTE in term infants with a 10-min Apgar score ≥8 to the Surveillance Unit for Rare Pediatric Conditions. Throughout 2010, the inclusion criteria were extended to infants ≥35 week gestational age and those where an explanation for the deterioration had been found. For each unexplained case, hospitals were asked to fill in a questionnaire for 3 (near-)term controls with good postnatal adaptation at the age (in minutes) when the event had occurred in the case under study.
Of the 85 cases reported, 34 fulfilled the entry criteria; of these, two were near-term newborns and, in three cases, a cause had been identified for the event. For the 31 cases with unknown cause for the event (13 males; mean (SD) gestational age 38.9 (1.7) week), the authors gathered 93 controls (51 male infants; 38.9 (1.4) week). As significant risk factors for S-ALTE and SID, the authors could identify primipara (OR 6.22; 95% CI 2.11 to 18.32) and potentially asphyxiating position (OR 6.45; 95% CI 1.22 to 34.10).
Close observation of newborns seems necessary, particularly in primipara; a potentially asphyxiating position should be avoided.
确定出生后 24 小时内意外婴儿猝死（SID）和严重明显的生命威胁事件（S-ALTE）的潜在风险因素。
在为期两年的流行病学调查中嵌入病例对照研究。
在 2009 年期间，德国的每个儿科部门都被要求向罕见儿科疾病监测单位报告无法解释的 SID 或 S-ALTE 在足月婴儿中，10 分钟 Apgar 评分≥8。在 2010 年期间，纳入标准扩展到≥35 孕周的婴儿和那些发现病情恶化的原因的婴儿。对于每例不明原因的病例，医院被要求为在研究病例中发生事件的年龄（分钟）时具有良好产后适应能力的 3 （近）足月对照者填写问卷。
报告的 85 例病例中，有 34 例符合纳入标准；其中，有两名是近足月新生儿，在 3 例病例中，确定了导致事件的原因。对于 31 例原因不明的事件病例（13 例男性；平均（SD）胎龄 38.9（1.7）周），作者收集了 93 例对照（51 例男性婴儿；38.9（1.4）周）。作为 S-ALTE 和 SID 的显著危险因素，作者可以确定初产妇（OR 6.22；95%CI 2.11 至 18.32）和潜在窒息位置（OR 6.45；95%CI 1.22 至 34.10）。
似乎需要密切观察新生儿，特别是初产妇；应避免潜在的窒息位置。
