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Esposito M, Sessa F, Nannola C, Pignotti MS, Greco P, Salerno M. Sudden unexpected postnatal collapse and BUB1B mutation: first forensic case report. Int J Legal Med 2024; 138:2049-2055. [PMID: 38664248 PMCID: PMC11306263 DOI: 10.1007/s00414-024-03231-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 04/03/2024] [Indexed: 08/09/2024]
Abstract
Sudden unexpected postnatal collapse (SUPC) is a sudden collapse of the clinical conditions of a full-term or near-term newborn, within the first 7 days of life, that requires resuscitation with positive ventilation and who either dies, has hypoxic-ischemic encephalopathy, or requires intensive care. The incidence of SUPC is very low, and most often presents a negative prognosis. The BUB1B gene is a mitotic checkpoint of serine/threonine kinase B that encodes a protein crucial for maintaining the correct number of chromosomes during cell division. Mutations in the BUB1B gene are linked to mosaic variegated aneuploidy syndrome 1 (MVA1), a rare autosomal recessive disorder characterized by diffuse mosaic aneuploidies involving several chromosomes and tissues. This paper discusses a case of a newborn who had a spontaneous delivery. After 2 h and 10 min, the infant showed generalized hypotonia and cyanosis, and his doctors performed orotracheal intubation, cardiac massage, pharmacological hemodynamic therapy, mechanical ventilation, antibiotic therapy, and hypothermic treatment. The newborn was discharged after 5 months with the diagnosis of hypoxic-ischemic encephalopathy. Suspecting an SUPC, a complete genetic analysis was performed demonstrating a compound heterozygous mutations in the BUB1B gene. The newborn died at 6 months of life, 1 month after discharge. A complete autopsy was performed, determining that the cause of death was due to sepsis starting from a brocopneumonic process, with outcomes of hypoxic-ischemic encephalopathy (HIE). In this scenario, it is not possible to demonstrate the causal effect of this mutation, considering that it could play a causal or concausal role in the onset of SUPC. Further research based on multicenter studies, as well as on animal models, could be very useful to clarify the pathological effect of this mutation.
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Affiliation(s)
| | - Francesco Sessa
- Department of Medical, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Catania, 95121, Italy
| | - Chiara Nannola
- Department of Translational Medical Sciences, Università degli Studi di Napoli "Federico II", Naples, 80125, Italy
| | - Maria Serenella Pignotti
- Department of Neonatology and Neonatal Intensive Care, Anna Meyer Children's Hospital, Florence, 50139, Italy
| | - Pantaleo Greco
- Department of Medical Sciences, Section of Obstetrics and Gynecology, University of Ferrara, Ferrara, 44121, Italy
| | - Monica Salerno
- Department of Medical, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Catania, 95121, Italy.
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Ludington-Hoe SM, Addison C. Sudden Unexpected Postnatal Collapse: Review and Management. Neonatal Netw 2024; 43:76-91. [PMID: 38599773 DOI: 10.1891/nn-2023-0059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
Sudden unexpected postnatal collapse (SUPC) of healthy newborns is a catastrophic event caused by cardiorespiratory collapse in a healthy newborn. The most common cause of SUPC is poor positioning of the newborn during skin-to-skin contact or breastfeeding when the newborn is not being observed by a health professional, attentive parent, or caretaker. Maternal/newborn health care professionals need to know about the essential information, definitions, incidence, risk factors, clinical presentation, outcomes, and prevention and management strategies to minimize the occurrence and impact of SUPC. A sample SUPC hospital policy is included in the manuscript.
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Hegyi T, Ostfeld BM. Sudden unexpected infant death risk profiles in the first month of life. J Matern Fetal Neonatal Med 2022; 35:10444-10450. [PMID: 36195459 DOI: 10.1080/14767058.2022.2128662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Limited improvement in current SUID rates requires further identification of its characteristics, including age-specific risk patterns. OBJECTIVE Compare SUID risk factors in the first week versus the remainder in the first month of life. DESIGN/METHODS We compared maternal and infant data from New Jersey databases for SUID from 2000 to 2015 in infants ≥ 34 weeks GA in the two groups. RESULTS In the period studied, 123 died in the first 27 days, 24 before seven. Deaths in the first week had a higher percentage of mothers with post-High School education (OR 3.50, CI: 1.38-8.87) and a primary Cesarean section delivery (OR 4.0, CI: 1.39-11.49), and a smaller percentage with inadequate prenatal care (OR 0.36, CI: 0.14, 0.94). A smaller percentage of first-week deaths had mothers who smoked during pregnancy or identified as Black, non-Hispanic, but these findings did not reach significance (p < .08 and p < .09, respectively). CONCLUSIONS SUID in the first week and the first month of life is rare. However, despite a limited sample size, data suggest that even within the first month of life, there are differences in risk patterns for SUID based on age at death. Age-specific profiles may lead to new hypotheses regarding causality and more refined risk-reduction guidelines and warrant further study.
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Affiliation(s)
- Thomas Hegyi
- Division of Neonatology, Department of Pediatrics and SIDS Center of New Jersey, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Barbara M Ostfeld
- Division of Neonatology, Department of Pediatrics and SIDS Center of New Jersey, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA
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Rodríguez-López J, De la Cruz Bértolo J, García-Lara NR, Asla Elorriaga I, Román Echevarría L, Vento M, Parra-Llorca A, Cabañas F, Lozano P, García-Algar Ó, Martín-Ancel A, Copons Fernández C, González Carrasco E, Olabarrieta Arnal I, Pellicer A, Marín Huarte N, Pallás-Alonso CR. Maternal and Neonatal Prognostic Factors for Cardiorespiratory Events in Healthy Term Neonates During Early Skin-to-Skin Contact. Front Pediatr 2022; 10:907570. [PMID: 35712622 PMCID: PMC9194510 DOI: 10.3389/fped.2022.907570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 05/02/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND During early skin-to-skin contact (ESSC), alterations in peripheral oxygen saturation (SpO2) and heart rate (HR) have been frequently observed. OBJECTIVES This study aimed to determine the incidence of cardiorespiratory events (CREs) during ESSC in healthy term newborns (HTNs) and estimate the association of maternal and neonatal prognostic factors with the risk of CREs. METHODS A pooled analysis of the cohort from a clinical trial involving healthy mother-child dyads during ESSC was performed. Pulse oximetry was employed to continuously monitor SpO2 and HR within 2 h after birth. The individual and combined prognostic relevance of the demographic and clinical characteristics of dyads for the occurrence of a CRE (SpO2 <91% or HR <111 or >180 bpm) was analyzed through logistic regression models. RESULTS Of the 254 children assessed, 169 [66.5%; 95% confidence interval (95% CI), 60.5-72.5%] had at least one CRE. The characteristics that increased the risk of CRE were maternal age ≥35 years (odds ratio, 2.21; 95% CI, 1.19-4.09), primiparity (1.96; 1.03-3.72), gestational body mass index (BMI) >25 kg/m2 (1.92; 1.05-3.53), and birth time between 09:00 p.m. and 08:59 a.m. (2.47; 1.02-5.97). CONCLUSION CREs were more frequent in HTNs born during nighttime and in HTNs born to first-time mothers, mothers ≥35 years, and mothers with a gestational BMI >25 kg/m2. These predictor variables can be determined during childbirth. Identification of neonates at higher risk of developing CREs would allow for closer surveillance during ESSC.
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Affiliation(s)
- Jesús Rodríguez-López
- Department of Neonatology, Health Research Institute Imas12, 12 de Octubre University Hospital, Complutense University, Madrid, Spain
| | | | - Nadia Raquela García-Lara
- Department of Neonatology, Health Research Institute Imas12, 12 de Octubre University Hospital, Complutense University, Madrid, Spain
| | | | | | - Máximo Vento
- Division of Neonatology, Neonatal Research Group, Health Research Institute La Fe, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - Anna Parra-Llorca
- Division of Neonatology, Neonatal Research Group, Health Research Institute La Fe, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - Fernando Cabañas
- Department of Pediatrics and Neonatology, Quirónsalud Madrid University Hospital, Madrid, Spain
| | - Pedro Lozano
- Department of Pediatrics and Neonatology, Quirónsalud Madrid University Hospital, Madrid, Spain
| | - Óscar García-Algar
- Neonatology Unit, Institut Clínic de Ginecologia, Obstetrícia i Nonatologia (ICGON), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clinic-Maternitat, Barcelona, Spain
| | - Ana Martín-Ancel
- Neonatology Unit, Sant Joan de Déu University Hospital and Clínic University Hospital, BCNatal, Barcelona, Spain
| | | | | | | | - Adelina Pellicer
- Department of Neonatology, La Paz University Hospital, Madrid, Spain
| | | | - Carmen Rosa Pallás-Alonso
- Department of Neonatology, Health Research Institute Imas12, 12 de Octubre University Hospital, Complutense University, Madrid, Spain
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Immediate and Sustained Skin-to-Skin Contact for Healthy Late Preterm and Term Newborns After Birth: AWHONN Practice Brief Number 14. Nurs Womens Health 2021; 25:e9-e11. [PMID: 34462236 DOI: 10.1016/j.nwh.2021.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Immediate and Sustained Skin-to-Skin Contact for Healthy Late Preterm and Term Newborns After Birth: AWHONN Practice Brief Number 14. J Obstet Gynecol Neonatal Nurs 2021; 50:e13-e15. [PMID: 34462182 DOI: 10.1016/j.jogn.2021.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Knipper NP, DiCioccio HC, Albert NM. What a Catch: Safety Intervention to Reframe Newborn Falls and Drops. MCN Am J Matern Child Nurs 2021; 46:161-167. [PMID: 33587342 DOI: 10.1097/nmc.0000000000000708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Parental fatigue rates after childbirth are high and may be associated with newborn drops that cause injury. Newborn drops and near-misses are potentially underreported due to parental embarrassment, shame, fear of reprisal, or guilt. Although newborn drops are rare, the leaders of mother-baby units need to enhance transparency of risk to assure a culture of safety. PURPOSE To describe components and outcomes of the What A Catch program, aimed at preventing newborn drops and addressing near-misses. METHODS The What A Catch program was implemented in two hospital mother-baby units. The five components of the program included maintaining a respite nursery, using visual management, positively framing situational communication and actions after a near-miss, safe and appropriate staffing, and celebrating and transparently displaying program successes. Data were collected on near-miss event rates and caregivers and families provided postevent comments. RESULTS The perinatal team embraced the program at both sites. Of 9,578 live births over 1 year, 202 near-misses or good catches were documented. Program leaders revise display the board multiple times per week. CLINICAL IMPLICATIONS Replication of this program is needed to determine if all five components are necessary to optimize a culture of safety. Future research may determine the scope of risk factors associated with newborn drops and near-misses, so that anticipated risk factors can be mitigated.
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Rodríguez-López J, De la Cruz Bértolo J, García-Lara NR, Núñez Vecino JL, Soriano-Ramos M, Asla Elorriaga I, Román Echevarría L, Pellicer A, Marín Huarte N, Vento M, Parra-Llorca A, Cabañas F, González Sánchez R, García-Algar Ó, Martín-Ancel A, Copons Fernández C, González Carrasco E, Beato M, Pallás-Alonso CR. Mother's Bed Incline and Desaturation Episodes in Healthy Term Newborns during Early Skin-to-Skin Contact: A Multicenter Randomized Controlled Trial. Neonatology 2021; 118:702-709. [PMID: 34695832 DOI: 10.1159/000519387] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 08/30/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Early skin-to-skin contact (ESSC) is associated with rare, sudden, unexpected postnatal collapse episodes. Placing the newborn in ESSC closer to an upright position may reduce the risk of airway obstruction and improve respiratory mechanics. This study assessed whether a greater inclination of the mother's bed during ESSC would reduce the proportion of healthy term newborns (HTNs) who experienced episodes of pulse oximeter saturation (SpO2) <91%. METHODS We conducted a multicenter randomized controlled trial comparing the effect of the mother's bed incline, 45° versus 15°, on desaturation in HTNs during ESSC. Before delivery on 1,271 dyads, randomization was conducted, and stringent criteria to select healthy mothers and term newborns were monitored until after birth. Preductal SpO2 was continuously monitored between 10 min and 2 h after birth. The primary outcome was the occurrence of at least one episode of SpO2 <91%. RESULTS 254 (20%) mother-infant dyads were eligible for analysis (45°, n = 126; 15°, n = 128). Overall, 57% (95% confidence interval [CI]: 51%-63%) of newborns showed episodes of SpO2 <91%. The proportion of infants with SpO2 <91% episodes was 52% in 45° and 62% in 15° (relative risk: 0.80; 95% CI: 0.6-1.07). CONCLUSIONS We did not show that a high mother bed inclination during ESSC led to significantly fewer HTNs who experienced episodes of SpO2 <91%. Desaturation episodes from 10 min to 2 h after birth occurred in more than half of HTNs.
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Affiliation(s)
- Jesús Rodríguez-López
- Department of Neonatology, Health Research Institute Imas12, Complutense University, Madrid, Spain
| | | | - Nadia Raquel García-Lara
- Department of Neonatology, Health Research Institute Imas12, Complutense University, Madrid, Spain
| | - José Luis Núñez Vecino
- Department of Neonatology, Health Research Institute Imas12, Complutense University, Madrid, Spain
| | - María Soriano-Ramos
- Department of Neonatology, Health Research Institute Imas12, Complutense University, Madrid, Spain
| | | | | | - Adelina Pellicer
- Department of Neonatology, La Paz University Hospital, Madrid, Spain
| | | | - Máximo Vento
- Division of Neonatology, Neonatal Research Group, Health Research Institute La Fe, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - Anna Parra-Llorca
- Division of Neonatology, Neonatal Research Group, Health Research Institute La Fe, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - Fernando Cabañas
- Department of Pediatrics and Neonatology, Quirónsalud Madrid University Hospital, Madrid, Spain
| | - Raquel González Sánchez
- Department of Pediatrics and Neonatology, Quirónsalud Madrid University Hospital, Madrid, Spain
| | - Óscar García-Algar
- Neonatology Unit, ICGON, IDIBAPS, Hospital Clinic-Maternitat, Barcelona, Spain
| | - Ana Martín-Ancel
- Neonatology Unit, Sant Joan de Déu University Hospital and Clínic University Hospital, Barcelona, Spain
| | | | | | - Maite Beato
- Neonatology Unit, Severo Ochoa University Hospital, Madrid, Spain
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Nadjafizadeh M, Caron FM. [Normal childbirth: physiologic labor support and medical procedures. Guidelines of the French National Authority for Health (HAS) with the collaboration of the French College of Gynaecologists and Obstetricians (CNGOF) and the French College of Midwives (CNSF) - Newborn care in the delivery room]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2020; 48:944-952. [PMID: 33011378 DOI: 10.1016/j.gofs.2020.09.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVES The purpose of this literature review is to make recommendations regarding the first steps and care provided to the healthy newborn. METHODS Consultation of the Medline database, and of national and international guidelines. RESULTS The initial assessment of the newborn should quickly determine whether resuscitation is necessary or not. Any anomaly requires the help of the pediatrician (Consensus agreement). For a newborn with no cardiorespiratory adaptation, delayed cord clamping may be considered more as a physiological modality of delivery, which may help prevent iron deficiency in the first months of life, without deleterious effects for the child or his/her mother, apart from a slightly increased risk of neonatal jaundice (gradeC). In order to avoid separating a woman and her child, it is recommended to postpone routine postnatal procedures, to allow for skin-to-skin contact between the mother and the newborn, if she wishes, according to a defined/specified surveillance protocol (grade B). Breastfeeding should be encouraged, and supported, especially the first time (Consensus agreement). In the absence of suggestive clinical signs, aspiration of the upper airways and systematic verification of the permeability of posterior nasal apertures and of the esophagus are not recommended (Consensus agreement). The prevention of hemorrhagic disease of the newborn by the oral administration of vitamin K1 to all healthy term babies begins in the delivery room, preferably in the presence of the parents and after having obtained their consent (Consensus agreement). CONCLUSION Regarding the birth of a healthy newborn, it is strongly advised to avoid unnecessary technical actions and to favor the mother-child relationship in a safe environment.
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Affiliation(s)
- M Nadjafizadeh
- Département Universitaire de Maieutique, UFR de Médecine, Université de Lorraine, 54505 Vandoeuvre-les-Nancy, France; CHRU de Nancy, 10, rue du Dr-Heydenreich, 54000 Nancy, France.
| | - F-M Caron
- Pôle femme enfant Victor-Pauchet, 80000 Amiens, France
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Maternity Nurses' Knowledge about Sudden Unexpected Postnatal Collapse and Safe Newborn Positioning. MCN Am J Matern Child Nurs 2020; 45:116-121. [PMID: 31804226 DOI: 10.1097/nmc.0000000000000597] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE Sudden unexpected postnatal collapse (SUPC) of healthy newborns in the first 2 days of life is increasing. These types of adverse events are known to be associated with unsafe positioning during skin-to-skin contact and breastfeeding. The purpose of the study was to determine maternity nurses' knowledge about SUPC and safe newborn positioning. DESIGN Nurses who participate in a hosted listserv were solicited to complete a questionnaire. METHODS An email with an embedded link to a 20-item questionnaire, the SUPC and Safe Positioning Knowledge Assessment Tool, and 16 demographic questions was sent to 605 maternity nurses in the United States who are part of a Perinatal Listserv for members of the Association of Women's Health, Obstetric and Neonatal Nurses. Scores were analyzed by mean, standard deviation, and percent correct answers. RESULTS Fifty questionnaires were initiated (response rate of 8.2%), and 36 completed questionnaires (response rate of 5.9%) were analyzed. Maternity nurses' knowledge of SUPC was less than their knowledge of safe newborn positioning (61% correct vs. 72% correct; p < 0.001). CLINICAL IMPLICATIONS Maternity nurses need more information about SUPC and safe newborn positioning, including risk factors, and effective strategies to reduce risk of preventable newborn harm.
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Barbaglia M, Finale E, Noce S, Vigo A, Arioni C, Visentin R, Scurati-Manzoni E, Guala A. Skin-to-skin contact and delivery room practices: a longitudinal survey conducted in Piedmont and the Aosta Valley. Ital J Pediatr 2019; 45:95. [PMID: 31375123 PMCID: PMC6679473 DOI: 10.1186/s13052-019-0688-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 07/24/2019] [Indexed: 01/25/2023] Open
Abstract
Background Sudden unexpected postnatal collapse of presumably healthy neonates during early skin-to-skin contact is a rare, yet recognized occurrence, associated with a high risk of mortality and morbidity. A survey was conducted in 2012 in 30 delivery wards throughout Piedmont and the Aosta Valley to evaluate the environmental and logistical aspects that could be linked to SUPC. The survey was again conducted in 2016 in 28 delivery wards in Piedmont and the Aosta Valley in order to evaluate organizational improvements introduced after ministerial indications and recommendations by the Italian Society of Neonatology were published in 2014, in light of new findings regarding the phenomenon. Methods A questionnaire specifically asking about the organization of delivery wards, and surveillance or supervision during early skin-to-skin contact, was sent to all of the hospitals taking part in the survey in both 2012 and 2016. The collected data were elaborated anonymously and the statistical analysis was performed by using the two by two table. Results In 2012, 28 out of 30 delivery wards in Piedmont and Aosta, with a total of 31,074 newborns out of 35,435, were evaluated in all of the environmental and logistical aspects that might be cause for SUPC to occur. An identical survey was taken again in 2016; 26 out of 28 wards participated with a total of 27,484 newborns out of 30,339. In 2012, early skin-to-skin contact took place immediately in all the delivery rooms in 27 wards, and soon after in the post-partum room in one; in 11 out of 28 wards there was early skin-to-skin contact in the operating theater itself, following caesarean sections (11/26 in 2016). Routine newborn care was given after 3 h in 8 delivery wards (7/26 in 2016); after 2 h in 12 (7/26 in 2016); after 1 h in 2 (4/26 in 2016); after 30 min in 3 (2/26 in 2016); after 10 min in 1 (0/26 in 2016); after 1 or 2 min in 1 (0/26 in 2016) and at any time in one ward (6/26 in 2016). Conclusion Periodic surveys of delivery wards are useful for the assessment of all the aspects and risk factors that need to be changed in order to implement safe early skin-to-skin contact. Electronic supplementary material The online version of this article (10.1186/s13052-019-0688-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Michelangelo Barbaglia
- Struttura Complessa Pediatria, Ospedale Castelli, Azienda Sanitaria Locale VCO, Verbania, Italy
| | - Enrico Finale
- Struttura Complessa Pediatria, Ospedale Castelli, Azienda Sanitaria Locale VCO, Verbania, Italy. .,Dipartimento Materno Infantile VCO, Ospedale Castelli, Verbania, Italy.
| | - Silvia Noce
- Centro di Riferimento Regionale per la SIDS, ASO/ OIRM/Sant'Anna, Torino, Italy
| | - Alessandro Vigo
- Centro di Riferimento Regionale per la SIDS, ASO/ OIRM/Sant'Anna, Torino, Italy
| | - Cesare Arioni
- Struttura Complessa Pediatria, Ospedale Umberto Parini, Azienda Sanitaria Locale della Valle d'Aosta, Aosta, Italy
| | - Raffaella Visentin
- Struttura Complessa Pediatria, Ospedale Castelli, Azienda Sanitaria Locale VCO, Verbania, Italy
| | | | - Andrea Guala
- Struttura Complessa Pediatria, Ospedale Castelli, Azienda Sanitaria Locale VCO, Verbania, Italy
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Hitchcock SC, Ruhl C. Nurses Leading Safe Infant Sleep Initiatives in the Hospital Setting. Nurs Womens Health 2019; 23:148-162. [PMID: 30975288 DOI: 10.1016/j.nwh.2019.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 09/22/2018] [Accepted: 01/01/2019] [Indexed: 06/09/2023]
Abstract
Every day, 10 otherwise healthy infants die from sleep-related deaths in the United States. These deaths, termed sudden unexpected infant death, remain the leading cause of post-neonatal death in the United States despite known modifiable risk factors and prevention recommendations. In birthing hospitals, many parents report being given incorrect and sometimes no information about infant sleep safety, which creates immediate and long-term safety concerns. In this article, we provide an overview of sudden unexpected infant death, including sudden unexpected postnatal collapse, and the latest safe sleep recommendations from the American Academy of Pediatrics. We also offer practical guidelines for nurses-those working at the bedside and those in leadership positions-who may be seeking to improve the quality of infant sleep practices in their organizations.
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Ludington-Hoe SM, Morrison-Wilford BL, DiMarco M, Lotas M. Promoting Newborn Safety Using the RAPPT Assessment and Considering Apgar Criteria: A Quality Improvement Project. Neonatal Netw 2018; 37:85-95. [PMID: 29615156 DOI: 10.1891/0730-0832.37.2.85] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The aim of this project was to evaluate the implementation of the Respiratory, Activity, Perfusion, Position, and Tone (RAPPT) instrument in assessing the infant's transition to extrauterine life while in skin-to-skin contact (SSC). Sample/Design: Nurses (n = 17) completed a pretest and posttest of RAPPT and Apgar scoring knowledge, attended an in-service about accurate scoring, and were observed during 17 deliveries when newborns were in SSC. OUTCOME VARIABLES Primary variables were knowledge scores, use of RAPPT, and accurate RAPPT scoring. Apgar scoring was also measured. RESULTS Knowledge scores increased significantly after education, RAPPT scores were correctly assessed, and 1 of 17 newborns had a sudden unexpected postnatal collapse. Apgar scoring accuracy did not change and nurses reported that their Apgar scores were based on their overall impressions of the infant instead of Apgar criteria.
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Rodriguez NA, Hageman JR, Pellerite M. Maternal distraction from smartphone use: a potential risk factor for sudden unexpected postnatal collapse of the newborn. J Pediatr 2018; 200:298-299. [PMID: 29784515 DOI: 10.1016/j.jpeds.2018.04.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 04/13/2018] [Indexed: 10/16/2022]
Affiliation(s)
- Nancy A Rodriguez
- Department of Pediatrics Division of Neonatology NorthShore University HealthSystem Evanston; Department of Pediatrics Division of Neonatology Pritzker School of Medicine The University of Chicago
| | - Joseph R Hageman
- Department of Pediatrics Division of Neonatology Pritzker School of Medicine The University of Chicago Chicago
| | - Matthew Pellerite
- Department of Pediatrics Division of Neonatology NorthShore University HealthSystem Evanston; Department of Pediatrics Division of Neonatology Pritzker School of Medicine The University of Chicago Chicago, Illinois
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The Baby Friendly Hospital Initiative and the ten steps for successful breastfeeding. a critical review of the literature. J Perinatol 2018; 38:623-632. [PMID: 29416115 DOI: 10.1038/s41372-018-0068-0] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 01/01/2018] [Accepted: 01/18/2018] [Indexed: 11/08/2022]
Abstract
There is no doubt regarding the multiple benefits of breastfeeding for infants and society in general. Therefore, the World Health Organization (WHO) in a conjoint effort with United Nations International Children's Emergency Fund (UNICEF) developed the "Ten Steps to Successful Breastfeeding" in 1992, which became the backbone of the Baby Friendly Hospital Initiative (BFHI). Following this development, many hospitals and countries intensified their position towards creating a "breastfeeding oriented" practice. Over the past two decades, the interest increased in the BFHI and the Ten Steps. However, alongside the implementation of the initiative, extensive research continues to evaluate the benefits and dangers of the suggested practices. Hence, it is our intention to make a critical evaluation of the current BFHI and the Ten Steps recommendations in consideration of the importance of providing an evidence-based breastfeeding supported environment for our mothers and infants.
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