Preventing sudden unexpected postnatal collapse: a narrative review
12 affiliations
- 1Division of Neonatology, Department of Paediatrics, Beatrix Children’s Hospital, University Medical Centre Groningen, PO Box 30.001, 9700 RD Groningen, the Netherlands
- 2Department of Neonatology, Emma Children’s Hospital, Amsterdam UMC, Amsterdam, the Netherlands
- 3Royal Dutch Association of Midwives (KNOV), Utrecht, the Netherlands
- 4Maternity Care Knowledge Centre, Hoofddorp, the Netherlands
- 5Department of Pediatrics, Albert Schweitzer Hospital, Dordrecht, the Netherlands
- 6Division of Obstetrics, Amsterdam UMC, Amsterdam, the Netherlands
- 7Child & Care Foundation (Stichting Kind & Zorg), Utrecht, the Netherlands
- 8Department of Obstetrics & Gynecology, University Medical Centre Groningen, Groningen, the Netherlands
- 9Division of Neonatology, Department of Pediatrics, Radboud University Medical Centre, Nijmegen, the Netherlands
- 10Division of Neonatology and Pediatric Intensive Care, University Hospital Eppendorf (UKE), Hamburg, Germany
- 11Neonatal and Pediatric Intensive Care, Erasmus MC, Rotterdam, the Netherlands
- 12Dutch Society for Pediatrics (NVK), Utrecht, the Netherlands
Abstract
Sudden unexpected postnatal collapse (SUPC) is a rare but significant safety issue in the immediate postnatal period, particularly during skin-to-skin contact (SSC). While international guidance suggests that SUPC is potentially preventable with targeted interventions, specific Dutch guidance is lacking. To synthesize national recommendations on SUPC prevention within an international context, a comprehensive search of PubMed, Embase, and relevant online sources (January 1st, 2012 to January 1st, 2025) identified international guidelines addressing SUPC prevention, focusing on SUPC risk factors and preventive measures including observation practices and frequency, standardized monitoring methods, parental involvement, infant positioning, and implementation feasibility taking account of parental privacy and staffing constraints. Twelve documents on SUPC guidance from ten countries were included. Agreement was observed regarding key risk factors and the need for continuous observation of the mother-infant dyad, but practical recommendations differed considerably. Variations were noted in observation duration and frequency, use of standardized monitoring tools, parental participation, and preferred infant positioning. Four guidelines explicitly addressed challenges related to discontinuous monitoring due to privacy or staffing constraints, and two provided post-event management protocols. Conclusion: International publications on SUPC prevention highlight risk factors and emphasise the need for continuous observation of the mother-infant dyad, although practical recommendations diverge markedly. The Dutch guidance on SUPC prevention integrates scientific evidence on SUPC, international guidance, and the clinical and organisational expertise of a multidisciplinary working group, and translates these insights into actionable recommendations for clinical practice before and after both hospital and home birth.
What is Known:
• International guidelines on SUPC prevention focus on safe SSC and surveillance of mother-infant dyads.
• Dutch protocols on SSC including SUPC prevention were scarce and varied widely.
What is New:
• International guidelines do not agree on the optimal postnatal observation of the mother-infant dyad.
• A novel Dutch SUPC prevention guidance provides practical recommendations as well as a clinical work-up after SUPC, applicable to both hospital and home settings.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s00431-026-07555-5.
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BibTeX
@article{bergman2026preventing,
title = {{Preventing sudden unexpected postnatal collapse: a narrative review}},
author = {Klasien A. Bergman and Moniek van de Loo and Suzanne M. Thompson and Betty Vries and Maikel Hustinx and Ingrid Vetter and Esen Cingir-Doganar and Maureen T. M. Franssen and René P. Matthijsse and Irwin K. M. Reiss and Triston S. Berkenbosch and Elisabeth M. W. Kooi and Christian V. Hulzebos},
journal = {European Journal of Pediatrics},
year = {2026},
month = oct,
doi = {10.1007/s00431-026-07555-5},
url = {https://doi.org/10.1007/s00431-026-07555-5},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Preventing sudden unexpected postnatal collapse: a narrative review
AU - Klasien A. Bergman
AU - Moniek van de Loo
AU - Suzanne M. Thompson
AU - Betty Vries
AU - Maikel Hustinx
AU - Ingrid Vetter
AU - Esen Cingir-Doganar
AU - Maureen T. M. Franssen
AU - René P. Matthijsse
AU - Irwin K. M. Reiss
AU - Triston S. Berkenbosch
AU - Elisabeth M. W. Kooi
AU - Christian V. Hulzebos
PY - 2026
DA - 2026/10/26
JO - European Journal of Pediatrics
DO - 10.1007/s00431-026-07555-5
UR - https://doi.org/10.1007/s00431-026-07555-5
AB - Sudden unexpected postnatal collapse (SUPC) is a rare but significant safety issue in the immediate postnatal period, particularly during skin-to-skin contact (SSC). While international guidance suggests that SUPC is potentially preventable with targeted interventions, specific Dutch guidance is lacking. To synthesize national recommendations on SUPC prevention within an international context, a comprehensive search of PubMed, Embase, and relevant online sources (January 1st, 2012 to January 1st, 2025) identified international guidelines addressing SUPC prevention, focusing on SUPC risk factors and preventive measures including observation practices and frequency, standardized monitoring methods, parental involvement, infant positioning, and implementation feasibility taking account of parental privacy and staffing constraints. Twelve documents on SUPC guidance from ten countries were included. Agreement was observed regarding key risk factors and the need for continuous observation of the mother-infant dyad, but practical recommendations differed considerably. Variations were noted in observation duration and frequency, use of standardized monitoring tools, parental participation, and preferred infant positioning. Four guidelines explicitly addressed challenges related to discontinuous monitoring due to privacy or staffing constraints, and two provided post-event management protocols. Conclusion: International publications on SUPC prevention highlight risk factors and emphasise the need for continuous observation of the mother-infant dyad, although practical recommendations diverge markedly. The Dutch guidance on SUPC prevention integrates scientific evidence on SUPC, international guidance, and the clinical and organisational expertise of a multidisciplinary working group, and translates these insights into actionable recommendations for clinical practice before and after both hospital and home birth. What is Known: • International guidelines on SUPC prevention focus on safe SSC and surveillance of mother-infant dyads. • Dutch protocols on SSC including SUPC prevention were scarce and varied widely. What is New: • International guidelines do not agree on the optimal postnatal observation of the mother-infant dyad. • A novel Dutch SUPC prevention guidance provides practical recommendations as well as a clinical work-up after SUPC, applicable to both hospital and home settings. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s00431-026-07555-5.
SN - 0340-6199
SN - 1432-1076
ER -