EARLY NEONATAL SUDDEN-DEATH OR NEAR-DEATH SYNDROME - AN EPIDEMIOLOGIC-STUDY OF 29 CASES

Early neonatal sudden death syndrome (SIDS) is a rare but well known d isease entity. Between January 1975 and December 1991, 29 full-term ne wborn infants delivered in our maternity unit and, considered healthy at birth, suffered early SIDS (n = 15) or early apparent life threaten ing events (ALTE) (n = 14). Data from the whole population of live ful l-term infants born in our hospital during the past five years have be en used as a reference (n = 27841). The general rate of early SIDS was 0.14 per 1000 (15/107 263). Combining early ALTE cases, the overall r ate was 0.27 per 1000 (29/107 263). A postmortem examination was perfo rmed for all infants who died (20/29): no cause of death could be dete rmined, and we did not observe a single case with evident sequelae. Th ere were 9 deaths (31%) within the first hour after delivery and 12 de aths occurred in the early morning hours (04:00-08:00; RR = 3.76; p = 0.0008). The lowest incidence was in the spring (RR = 0.21; p = 0.03). There was a tendency for an increased incidence during the weekend an d the summer. No influence of sex, maternal age, gestational age, infa nt weight presentation, delivery, anesthesia or presence of meconium-s tained fluid was found. In our opinion, SIDS can take place even durin g the first hour of life and it is not possible to predict when a baby might be affected. Pediatrically trained caregivers, close observatio n by the mother during the first few days and resuscitation facilities in maternity wards may be the most important preventive measures to r educe the risk of early SIDS and the consequences of ALTE in the early newborn period.