3日龄健康足月顺产女婴，Apgar评分：1 min 10分、5 min 10分，生后第3天凌晨母婴同床时突发心跳、呼吸停止，经积极抢救恢复自主呼吸及心跳，复苏时间持续约10 min，复苏后患儿反应差并出现抽搐，血气分析提示代谢性酸中毒，振幅整合脑电图提示爆发-抑制图形，诊断为新生儿生后突发意外衰竭。该患儿经亚低温及对症支持治疗，病情好转。该文首次报道国内1例新生儿生后突发意外衰竭，并对其危险因素、病理生理机制、预防和治疗措施进行总结。
Abstract：A healthy full-term female neonate, aged 3 days and born by vaginal delivery (with a 1-minute Apgar score of 10 and a 5-minute Apgar score of 10), had unexpected cardiac and respiratory arrests in the early morning on day 3 after birth and recovered to spontaneous breathing and heartbeat after a 10-minute resuscitation. The child had poor response and convulsion after resuscitation. Blood gas analysis showed metabolic acidosis, and amplitude-integrated EEG showed a burst-suppression pattern. She was diagnosed with sudden unexpected postnatal collapse but improved after hypothermia and symptomatic/supportive treatment. This article reports the first case of sudden unexpected postnatal collapse in China and summarizes related risk factors, pathophysiological mechanisms, and preventive and treatment measures of this disorder.
Miyazawa T, Itabashi K, Tamura M, et al. Unsupervised breastfeeding was related to sudden unexpected postnatal collapse during early skin-to-skin contact in cerebral palsy cases[J]. Acta Paediatr, 2020, 109(6):1154-1161.
[3]
Herlenius E, Kuhn P. Sudden unexpected postnatal collapse of newborn infants:a review of cases, definitions, risks, and preventive measures[J]. Transl Stroke Res, 2013, 4(2):236-247.
De Rosa G, De Carolis MP, Tempera A, et al. Outcome of neonates with vein of Galen malformation presenting with severe heart failure:a case series[J]. Am J Perinatol, 2019, 36(2):169-175.
Association of Women's Health, Obstetric and Neonatal Nurses. Sudden unexpected postnatal collapse in healthy term newborns:AWHONN practice brief number 8[J]. Nurs Womens Health, 2020, 24(4):300-302.
[8]
Lutz TL, Elliott EJ, Jeffery HE. Sudden unexplained early neonatal death or collapse:a national surveillance study[J]. Pediatr Res, 2016, 80(4):493-498.
[9]
Obonai T, Asanuma M, Mizuta R, et al. Evidence of brain ischemia in early neonatal sudden death syndrome[J]. Neuropediatrics, 1997, 28(3):145-148.
[10]
Lavezzi AM, Ferrero S, Paradiso B, et al. Neuropathology of early sudden infant death syndrome-hypoplasia of the pontine Kolliker-Fuse nucleus:a possible marker of unexpected collapse during skin-to-skin care[J]. Am J Perinatol, 2019, 36(5):460-471.
[11]
Bautista TG, Dutschmann M. Inhibition of the pontine Kölliker-Fuse nucleus abolishes eupneic inspiratory hypoglossal motor discharge in rat[J]. Neuroscience, 2014, 267:22-29.
[12]
Harris MB, Milsom WK. Apneusis follows disruption of NMDA-type glutamate receptors in vagotomized ground squirrels[J]. Respir Physiol Neurobiol, 2003, 134(3):191-207.
[13]
Barbaglia M, Finale E, Noce S, et al. Skin-to-skin contact and delivery room practices:a longitudinal survey conducted in Piedmont and the Aosta Valley[J]. Ital J Pediatr, 2019, 45(1):95.
[14]
Ludington-Hoe SM, Morrison-Wilford BL, Dimarco M, et al. Promoting newborn safety using the RAPPT assessment and considering Apgar criteria:a quality improvement project[J]. Neonatal Netw, 2018, 37(2):85-95.
[15]
Echeverría-Palacio CM, Agut T, Arnaez J, et al. Neuron-specific enolase in cerebrospinal fluid predicts brain injury after sudden unexpected postnatal collapse[J]. Pediatr Neurol, 2019, 101:71-77.
[16]
Smit E, Liu X, Jary S, et al. Cooling neonates who do not fulfil the standard cooling criteria-short- and long-term outcomes[J]. Acta Paediatr, 2015, 104(2):138-145.
