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December 2, 1939


JAMA. 1939;113(23):2038-2046. doi:10.1001/jama.1939.02800480024007

Asphyxia of the newborn infant has assumed an entirely new significance in recent years for two reasons: a greatly modified conception of the inauguration of respiration and the demonstration of the various pathologic changes that may be produced in the central nervous system by anoxia. Until very recently it had always been supposed that the normal baby was born in a state of physiologic apnea and that as the placental circulation ceased to function the accumulation of carbon dioxide in the blood stimulated the respiratory center and caused respiration to begin.

The studies of Snyder and Rosenfeld1 have caused us to change this conception almost completely. They have shown beyond much question of doubt that the movements of respiration do not start suddenly at the time of birth but occur in regular rhythm during the latter third of intra-uterine life. According to them there is little essential difference between