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Updated: Jul 26, 2026

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Pattern of illnesses before cot deaths
Insights
Babies who died unexpectedly were more likely to have had prior hospital admissions than controls. These admissions often indicated underlying family issues, suggesting a need for further investigation into infant mortality causes.
Area of Science:
- Pediatrics
- Public Health
- Child Development
Background:
- Understanding reasons for infant hospitalization is crucial for preventing postneonatal mortality.
- Previous hospital admissions may serve as indicators for infants at higher risk of unexpected death.
Purpose of the Study:
- To analyze and compare hospital referral reasons for infants who later died unexpectedly versus control infants.
- To identify factors contributing to increased hospital admissions in infants experiencing unexpected mortality.
Main Methods:
- Retrospective analysis of hospital referral reasons for 147 infants in a postneonatal mortality study.
- Comparison with 104 control infants regarding prior hospital admissions and reasons.
Main Results:
- 16% of infants who died unexpectedly had prior hospital admissions, compared to only 28 controls.
- Excess admissions in the deceased group were linked to acute infections, loss of consciousness, suspected child abuse, and non-organic failure to thrive.
- Infants who died unexpectedly had longer average hospital stays and higher rates of multiple admissions.
Conclusions:
- Prior hospital admissions can be significant indicators of underlying issues in infants at risk of unexpected death.
- The findings highlight the potential for early identification of family problems through hospital admission records.
- Unexplained apnea and 'near miss' cot deaths may not fully represent models for investigating most unexpected infant deaths.
Abstract:
The reasons for referral to hospital of 147 babies subsequently included in the DHSS study of postneonatal infant mortality were analysed and compared with those of 104 control infants. Although similar numbers were seen as outpatients, 71 (16%) of the babies who died unexpectedly, but only 28 controls had previously been admitted to hospital. The excess was explained by acute infections, loss of consciousness, possible child abuse, and failure to thrive for non-organic reasons. The average length of admission was almost twice that required by controls, and 31% were admitted more than once. The admissions were often clues to important family problems that might have been investigated further. There were no admissions for unexplained apnoea and 'near miss' cot deaths may not therefore represent a suitable model for the investigation of most unexpected deaths during infancy.
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