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Am J Perinatol 2011; 28(1): 075-082
DOI: 10.1055/s-0030-1262906
© Thieme Medical Publishers

The Apparently Stillborn Infant: Risk Factors, Incidence, and Neonatal Outcome

Kristi Nelson1 , 2 , Sara E. Simonsen3 , Erick Henry1 , Stephanie Wilder2 , Nancy C. Rose1 , 2
  • 1Intermountain Healthcare, Salt Lake City, Utah
  • 2Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah
  • 3Division of Public Health, University of Utah, Salt Lake City, Utah
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Publication History

Publication Date:
19 July 2010 (online)

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ABSTRACT

We evaluated neonatal outcomes of apparently stillborn infants. The apparently stillborn neonate is born with an unexpected Apgar score of 0 at 1 minute and is subsequently successfully resuscitated. A retrospective cohort study was performed using electronic medical records for neonates >24 weeks' gestation born between 2002 and 2007. Adverse outcome was defined by the presence of seizures, encephalopathy, or death prior to hospital discharge. Differences in maternal demographics and clinical characteristics were compared between neonates with and without adverse outcomes at varying hospital settings. Ninety-three neonates were identified as apparently stillborn. Adverse outcomes occurred in 31.2% of neonates; 83.9% survived from birth to hospital discharge. Neonates with a 5-minute Apgar score <4 were significantly more likely to suffer an adverse outcome. Survival of the apparent stillborn is likely. In this cohort, neither mode of delivery nor hospital acuity level predicted outcome.

KEYWORDS

Apgar - apparently stillborn - neonatal resuscitation - obstetrical outcome

REFERENCES

  • 1 Apgar V. A proposal for a new method of evaluation of the newborn infant.  Curr Res Anest Anal. 1953;  32 260-267
    PubMedGoogle Scholar
  • 2 Scott H. Outcome of very severe birth asphyxia.  Arch Dis Child. 1976;  51 712-716
    CrossrefPubMedGoogle Scholar
  • 3 Jain L, Ferre C, Vidyasagar D, Nath S, Sheftel D. Cardiopulmonary resuscitation of apparently stillborn infants: survival and long-term outcome.  J Pediatr. 1991;  118 778-782
    CrossrefPubMedGoogle Scholar
  • 4 Thomson A J, Searle M, Russell G. Quality of survival after severe birth asphyxia.  Arch Dis Child. 1977;  52 620-626
    CrossrefPubMedGoogle Scholar
  • 5 Casalaz D M, Marlow N, Speidel B D. Outcome of resuscitation following unexpected apparent stillbirth.  Arch Dis Child Fetal Neonatal Ed. 1998;  78 F112-F115
    CrossrefPubMedGoogle Scholar
  • 6 Haddad B, Mercer B M, Livingston J C, Sibai B M. Obstetric antecedents to apparent stillbirth (Apgar score zero at 1 minute only).  Obstet Gynecol. 2001;  97 961-964
    CrossrefPubMedGoogle Scholar
  • 7 Haddad B, Mercer B M, Livingston J C, Talati A, Sibai B M. Outcome after successful resuscitation of babies born with Apgar scores of 0 at both 1 and 5 minutes.  Am J Obstet Gynecol. 2000;  182 1210-1214
    CrossrefPubMedGoogle Scholar
  • 8 Harrington D J, Redman C W, Moulden M, Greenwood C E. The long term outcome in surviving infants with Apgar zero at 10 minutes: a systematic review of the literature and hospital-based cohort.  Am J Obstet Gynecol. 2007;  196 463.e1-463.e5
    PubMedGoogle Scholar
  • 9 International Liaison Committee on Resuscitation . The International Liaison Committee on Resuscitation (ILCOR) consensus on science with treatment recommendations for pediatric and neonatal patients: neonatal resuscitation.  Pediatrics. 2006;  117 e978-e988
    CrossrefPubMedGoogle Scholar

Nancy C RoseM.D. 

Suite D-100, Maternal Fetal Medicine, Intermountain Medical Center

5121 S. Cottonwood Street, Salt Lake City, UT 84157

Email: Nancy.rose@imail.org

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