Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Sudden infant death syndrome: collaborative approach needed

02.11.2007
Tackling sudden infant death syndrome (SIDS) requires a collaborative effort that engages health professionals and policymakers, researchers, medical examiners and coroners, grief counsellors and family support agencies, and most of all families and communities. These are the conclusions of authors of a Seminar in this week’s edition of The Lancet.

SIDS is defined as “the sudden death of an infant under one year of age, which remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene, and review of the clinical history.” SIDS is the leading cause of death for infants aged between one month and one year in developed countries. Lowest rates of SIDS in these countries are in Japan and The Netherlands (0.09 and 0.1 per 1000 live births, respectively). The UK rate is 0.41, the USA 0.57, and the highest rate for developed countries is in New Zealand, at 0.8 per 1000 livebirths.

Dr Rachel Moon, Children’s National medical Centre, Washington, DC, USA and colleagues say that campaigns to place children on their backs during sleep have massively reduced SIDS incidence, by between 50-90%. The age when infants are at highest risk is between two and four months, and 90% of SIDS deaths happen in the first six months of life. Boys are more likely than girls to die from SIDS, at a ratio of 60:40. Ethnic differences are also risk factors for SIDS. Infants in the USA who are African American, Native American or Alaska Native have SIDS rates two to three times the national average. Aboriginal Australian and Maori New Zealander infants are also at higher risk – with Maori infants six times more likely than the New Zealand population average to die from SIDS.

The authors discuss other SIDS risk factors, including maternal smoking during pregnancy. They say: “If in-utero smoke exposure was eliminated, a third of SIDS deaths could possibly be prevented.” As well as infants sleeping on their side or front, other SIDS risk factors include soft bedding and surfaces, warmer room temperatures, multiple layers of clothing or blankets, and bed sharing. The risk from bed sharing is particularly high when there are multiple bed sharers, when the infant is younger than 11 weeks, and when bed sharing occurs for the entire night. When the adult(s) sharing the bed is overtired or has consumed alcohol , this risk could increase further. However, there is growing evidence that room sharing without bed sharing – eg. having the infants crib in the same room – is associated with reduced risk of SIDS. Use of a pacifier (dummy) at sleep time has also been shown to reduce SIDS risk – even when the pacifier may become dislodged from the mouth shortly after sleep onset. This displacement could disrupt sleep and make the child more easily aroused from sleep, allowing increased responsiveness to a life-threatening challenge.

Infants in child-care settings make up 20% of SIDS deaths; the reasons for this are unclear. A large proportion of these deaths are in the first week of child care; thus stress and sleep disruption could be contributory factors.

Other risk factors discussed are low birth weight/premature birth, breastfeeding, and recurrence of SIDS in siblings. Siblings of SIDS victims are more likely to die from SIDS themselves than the general population. Although homicide should be considered as a possibility, a SIDS death in subsequent sibling is six times more likely to be SIDS than homicide. Pathophysiology of SIDS, autopsy and genetic factors are also discussed in the Seminar.

The authors say: “By definition, SIDS is a diagnosis of exclusion. Protocols for standardised autopsies and death scene investigations in sudden unexpected infant deaths have been published. However, there is wide variability in both the content and frequency with which these protocols are implemented across jurisdictions, both within countries and across different countries.”

They also say that the messages of established risk reduction interventions, such as infants sleeping on their backs and avoidance of smoke exposure in-utero, should be continually reinforced to new generations of health providers, parents, and carers. The American Academy of Pediatrics SIDS risk reduction recommendations, 2005 are also discussed.

The authors conclude that monitoring trends of SIDS is crucial. They say: “Continued research, surveillance, risk reduction campaigns, and standardisation of autopsy and scene investigation protocols and classification of deaths are all essential pieces to illuminating the SIDS puzzle and reaching our shared goal of eliminating it as a cause of infant death.”

Tony Kirby | alfa
Further information:
http://multimedia.thelancet.com/pdf/press/Seminar.pdf

More articles from Health and Medicine:

nachricht Electrical 'switch' in brain's capillary network monitors activity and controls blood flow
27.03.2017 | Larner College of Medicine at the University of Vermont

nachricht Laser activated gold pyramids could deliver drugs, DNA into cells without harm
24.03.2017 | Harvard John A. Paulson School of Engineering and Applied Sciences

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Giant Magnetic Fields in the Universe

Astronomers from Bonn and Tautenburg in Thuringia (Germany) used the 100-m radio telescope at Effelsberg to observe several galaxy clusters. At the edges of these large accumulations of dark matter, stellar systems (galaxies), hot gas, and charged particles, they found magnetic fields that are exceptionally ordered over distances of many million light years. This makes them the most extended magnetic fields in the universe known so far.

The results will be published on March 22 in the journal „Astronomy & Astrophysics“.

Galaxy clusters are the largest gravitationally bound structures in the universe. With a typical extent of about 10 million light years, i.e. 100 times the...

Im Focus: Tracing down linear ubiquitination

Researchers at the Goethe University Frankfurt, together with partners from the University of Tübingen in Germany and Queen Mary University as well as Francis Crick Institute from London (UK) have developed a novel technology to decipher the secret ubiquitin code.

Ubiquitin is a small protein that can be linked to other cellular proteins, thereby controlling and modulating their functions. The attachment occurs in many...

Im Focus: Perovskite edges can be tuned for optoelectronic performance

Layered 2D material improves efficiency for solar cells and LEDs

In the eternal search for next generation high-efficiency solar cells and LEDs, scientists at Los Alamos National Laboratory and their partners are creating...

Im Focus: Polymer-coated silicon nanosheets as alternative to graphene: A perfect team for nanoelectronics

Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are less stable. Now researchers at the Technical University of Munich (TUM) have, for the first time ever, produced a composite material combining silicon nanosheets and a polymer that is both UV-resistant and easy to process. This brings the scientists a significant step closer to industrial applications like flexible displays and photosensors.

Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are...

Im Focus: Researchers Imitate Molecular Crowding in Cells

Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to simulate these confined natural conditions in artificial vesicles for the first time. As reported in the academic journal Small, the results are offering better insight into the development of nanoreactors and artificial organelles.

Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

International Land Use Symposium ILUS 2017: Call for Abstracts and Registration open

20.03.2017 | Event News

CONNECT 2017: International congress on connective tissue

14.03.2017 | Event News

ICTM Conference: Turbine Construction between Big Data and Additive Manufacturing

07.03.2017 | Event News

 
Latest News

Northern oceans pumped CO2 into the atmosphere

27.03.2017 | Earth Sciences

Fingerprint' technique spots frog populations at risk from pollution

27.03.2017 | Life Sciences

Big data approach to predict protein structure

27.03.2017 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>