Lutz Tracey L, Elliott Elizabeth J, Jeffery Heather E
Department of Public Health, University of Sydney, Sydney, Australia.
The Department of Newborn Care, Royal Prince Alfred Hospital, Sydney, Australia.
Pediatr Res. 2016 Oct;80(4):493-8. doi: 10.1038/pr.2016.110. Epub 2016 May 24.
The incidence of sudden unexpected early neonatal death (SUEND) or acute life-threatening events (ALTEs) is reported as 0.05/1,000 to 0.38/1,000 live births. There is currently no national system in Australia for reporting and investigating such cases.
A 3-y prospective, national surveillance study, run in collaboration with the Australian Pediatric Surveillance Unit (APSU). Data were provided by pediatricians reporting to APSU; and independently ascertained by the Coroner in two states (NSW and QLD) and the Newborn Early Transport Network in NSW. A detailed deidentified questionnaire was created.
In NSW and QLD, the incidence was 0.1 and 0.08/1,000 live births, respectively. Forty-eight definitive cases were identified. Common causes included accidental asphyxia, cardiac disease, persistent pulmonary hypertension of the newborn, and sudden infant death syndrome. Twenty-six babies collapsed on day 1 and 19 were found on the carer's chest.
The incidence in NSW and QLD is higher than previously published. The first postnatal day is a vulnerable period for newborns, who require close observation particularly during skin-to-skin contact. Development and implementation of guidelines for safe sleeping in hospital are needed. Collaboration between obstetricians, midwives, and pediatricians is essential to ensure safety of the newborn.
据报道，新生儿早期意外猝死（SUEND）或急性危及生命事件（ALTE）的发生率为每1000例活产中有0.05至0.38例。澳大利亚目前没有全国性的系统来报告和调查此类病例。
与澳大利亚儿科监测单位（APSU）合作开展了一项为期3年的全国前瞻性监测研究。数据由向APSU报告的儿科医生提供；并由新南威尔士州（NSW）和昆士兰州（QLD）的验尸官以及新南威尔士州的新生儿早期转运网络独立确定。创建了一份详细的匿名问卷。
在新南威尔士州和昆士兰州，发生率分别为每1000例活产中有0.1例和0.08例。确定了48例确诊病例。常见原因包括意外窒息、心脏病、新生儿持续性肺动脉高压和婴儿猝死综合征。26名婴儿在出生第1天出现虚脱，19名婴儿被发现趴在护理人员的胸口。
新南威尔士州和昆士兰州的发生率高于此前公布的数字。出生后的第一天是新生儿的脆弱期，尤其是在进行皮肤接触期间，需要密切观察。需要制定和实施医院安全睡眠指南。产科医生、助产士和儿科医生之间的合作对于确保新生儿安全至关重要。
