Not Crying After Birth as a Predictor of Not Breathing
Not Crying After Birth as a Predictor of Not Breathing
复制标题
DOI：
10.1542/peds.2019-2719
复制
发表时间：
2020-06-01
期刊：
影响因子：
8
通讯作者：
Singhal, Nalini
中科院分区：
文献类型：
--
作者：
Ashish, K. C.;Lawn, Joy E.;Singhal, Nalini
背景：根据对“无呼吸”婴儿的有限数据的估计，全世界每年有600万至1000万婴儿在出生时需要复苏。在这篇文章中，我们的目的是描述的发病率“非哭”和非呼吸的婴儿出生后，需要基本复苏与袋和面罩通气，和死亡前discharge.METHODS：我们进行了一项观察性研究，19977年在尼泊尔的4家医院的婴儿。我们分析了出生后不哭或不呼吸婴儿的发生率。结果：新生儿出生后即刻不哭的发生率为11.1%，不哭不呼吸的发生率为5.2%。出生后不哭对出生后无呼吸的婴儿有100%的敏感性。在“不哭但有呼吸”的婴儿中，9.5%的婴儿在1分钟内没有呼吸，2%的婴儿在5分钟内没有呼吸。出生后不哭但有呼吸的婴儿出院前死亡率的几率几乎为12倍（调整后的比值比为12.3; 95%可信区间为5.8-26.1）。一部分出生时不哭但有呼吸的婴儿在1分钟和5分钟内没有呼吸，有出院前死亡的风险。通过这项研究，我们提供了不哭和不呼吸之间存在联系的证据。这项研究表明，不哭但有呼吸的婴儿需要额外的护理。我们建议将不哭作为开始复苏的临床体征，并作为衡量复苏覆盖率的可能分母。
BACKGROUND:Worldwide, every year, 6 to 10 million infants require resuscitation at birth according to estimates based on limited data regarding "nonbreathing" infants. In this article, we aim to describe the incidence of "noncrying" and nonbreathing infants after birth, the need for basic resuscitation with bag-and-mask ventilation, and death before discharge.METHODS:We conducted an observational study of 19977 infants in 4 hospitals in Nepal. We analyzed the incidence of noncrying or nonbreathing infants after birth. The sensitivity of noncrying infants with nonbreathing after birth was analyzed, and the risk of predischarge mortality between the 2 groups was calculated.RESULTS:The incidence of noncrying infants immediately after birth was 11.1%, and the incidence of noncrying and nonbreathing infants was 5.2%. Noncrying after birth had 100% sensitivity for nonbreathing infants after birth. Among the "noncrying but breathing" infants, 9.5% of infants did not breathe at 1 minute and 2% did not to breathe at 5 minutes. Noncrying but breathing infants after birth had almost 12-fold odds of predischarge mortality (adjusted odds ratio 12.3; 95% confidence interval, 5.8-26.1).CONCLUSIONS:All nonbreathing infants after birth do not cry at birth. A proportion of noncrying but breathing infants at birth are not breathing by 1 and 5 minutes and have a risk for predischarge mortality. With this study, we provide evidence of an association between noncrying and nonbreathing. This study revealed that noncrying but breathing infants require additional care. We suggest noncrying as a clinical sign for initiating resuscitation and a possible denominator for measuring coverage of resuscitation.