Influence of increased survival in very low birth weight, low birth weight, and normal birth weight infants on the incidence of sudden infant death syndrome in the United States: 1985-1991

Background: Sudden infant death syndrome (SIDS) is one of the leading causes of infant mortality in the United States (US). The extent to which SIDS manifests with an underlying neuropathological mechanism is highly controversial. SIDS correlates with markers of poor prenatal and postnatal care, generally rooted in the lack of access and quality of healthcare endemic to select racial and ethnic groups, and thus can be viewed in the context of health disparities. However, some evidence suggests that at least a subset of SIDS cases may result from a neuropathological mechanism. To explain these issues, a triple-risk hypothesis has been proposed, whereby an underlying biological abnormality in an infant facing an extrinsic risk during a critical developmental period SIDS is hypothesized to occur. Each SIDS decedent is thus thought to have a unique combination of these risk factors leading to their death. This article reviews the neuropathological literature of SIDS and uses machine learning tools to identify distinct subtypes of SIDS decedents based on epidemiological data.Methods: We analyzed US Period Linked Birth/Infant Mortality Files from 1990 to 2017 (excluding 1992–1994). Using t-SNE, an unsupervised machine learning dimensionality reduction algorithm, we identified clusters of SIDS decedents. Following identification of these groups, we identified changes in the rates of SIDS at the state level and across three countries.Results: Through t-SNE and distance based statistical analysis, we identified three groups of SIDS decedents, each with a unique peak age of death. Within the US, SIDS is geographically heterogeneous. Following this, we found low birth weight and normal birth weight SIDS rates have not been equally impacted by implementation of clinical guidelines. We show that across countries with different levels of cultural heterogeneity, reduction in SIDS rates has also been distinct between decedents with low vs. normal birth weight.Conclusions: Different epidemiological and extrinsic risk factors exist based on the three unique SIDS groups we identified with t-SNE and distance based statistical measurements. Clinical guidelines have not equally impacted the groups, and normal birth weight infants comprise more of the cases of SIDS even though low birth weight infants have a higher SIDS rate.

Download Full-text

Infant Mortality: A Practical Approach to the Analysis of the Leading Causes of Death and Risk Factors

PEDIATRICS ◽

10.1542/peds.86.2.176 ◽

1990 ◽

Vol 86 (2) ◽

pp. 176-183

Author(s):

Catherine Dollfus ◽

Michael Patetta ◽

Earl Siegel ◽

Alan W. Cross

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Sudden Infant Death Syndrome ◽

Infant Death ◽

Congenital Anomalies ◽

Causes Of Death ◽

Very Low Birth Weight ◽

Birth Certificate ◽

Sudden Infant Death ◽

Sudden Infant

The analysis of infant mortality data provides an opportunity for developing preventive strategies to improve this indicator of a population's health. All infant deaths in North Carolina during a 5-year period (1980 through 1984) were analyzed using the International Classification of Diseases, 9th revision (ICD-9), and a system for linked birth and death records that allows the analysis of birth certificate information on deaths. Causes of death were aggregated based on common etiology such as prematurity or obstetric-related conditions rather than the more traditional organ system taxonomy of the ICD-9 codes. Analyses were carried out separately for very low birth weight (≤1500 g), moderately low birth weight (1501 through 2500 g), and normal birth weight (>2500 g) babies. Maternal characteristics identified from the birth certificate were also compared with the different causes of death. Prematurity-related conditions accounted for 37.5% of all deaths, ranking far above the 17.4% for congenital anomalies and 12.9% for sudden infant death syndrome. For normal birth weight babies, sudden infant death syndrome ranked first, followed by congenital anomalies and nonperinatal infections. For the moderately low birth weight babies, congenital anomalies ranked first, with sudden infant death syndrome second and prematurity-related conditions third. For the very low birth weight babies, prematurity-related conditions accounted for nearly 70% of the deaths, with obstetric conditions and congenital anomalies ranking second and third, respectively. Maternal risk factors identified an overrepresentation of nonwhite, unmarried, and young teenage mothers and mothers with less than adequate prenatal care. This system for analyzing infant deaths provides an opportunity to devise preventive strategies by identifying common underlying conditions, such as prematurity, that account for a high proportion of deaths.

Download Full-text

Age at Death, Season, and Day of Death as Indicators of the Effect of the Back to Sleep Program on Sudden Infant Death Syndrome in the United States, 1992-1999

Archives of Pediatrics and Adolescent Medicine ◽

10.1001/archpedi.158.4.359 ◽

2004 ◽

Vol 158 (4) ◽

pp. 359 ◽

Cited By ~ 27

Author(s):

Michael H. Malloy ◽

Daniel H. Freeman

Keyword(s):

United States ◽

Sudden Infant Death Syndrome ◽

Infant Death ◽

Sudden Infant Death ◽

The United States ◽

Sudden Infant ◽

Age At Death ◽

Back To Sleep

Download Full-text

Will Neonatology Vanish in 1995?

PEDIATRICS ◽

10.1542/peds.77.5.792 ◽

1986 ◽

Vol 77 (5) ◽

pp. 792-793

Author(s):

EMILE PAPIERNIK

Keyword(s):

United States ◽

Birth Weight ◽

Low Birth Weight ◽

Prevention Program ◽

Very Low Birth Weight ◽

The United States ◽

Low Birth Weight Infants

In Reply.— The interest of neonatologists in preventing preterm deliveries is remarkable in the United States. In France, where a policy of prevention was developed nationally in 1971, the first impulse also came from the neonatologists and specifically Alex Minkowski, who challenged the obstetricians to propose a real prevention program. The results of this program have now been published.1 incidence of very low birth weight infants in France in 1972 was 0.8 and in 1981 0.4.2

Download Full-text

Association of Poverty with Sudden Infant Death Syndrome in Metropolitan Counties of the United States in the Years 1990 and 2000

Southern Medical Journal ◽

10.1097/smj.0b013e318158b9de ◽

2007 ◽

Vol 100 (11) ◽

pp. 1107-1113 ◽

Cited By ~ 13

Author(s):

Michael H. Malloy ◽

Karl Eschbach

Keyword(s):

United States ◽

Sudden Infant Death Syndrome ◽

Infant Death ◽

Sudden Infant Death ◽

The United States ◽

Sudden Infant ◽

Metropolitan Counties

Download Full-text

IS BEING A PREMATURE OR HAVING ABNORMAL BIRTH WEIGHT ASSOCIATED WITH DEPRESSION AMONG 6 - 17 YEARS OLD U.S. CHILDREN?

Paediatrics & Child Health ◽

10.1093/pch/pxy054.130 ◽

2018 ◽

Vol 23 (suppl_1) ◽

pp. e51-e51

Author(s):

Abdulaziz Bahassan ◽

Colin Depp

Keyword(s):

Mental Health ◽

United States ◽

Birth Weight ◽

Low Birth Weight ◽

Very Low Birth Weight ◽

The United States ◽

Chronic Health Conditions ◽

Health Conditions ◽

Chronic Health ◽

History Of

Abstract BACKGROUND Reports in 2015 showed that premature birth rate in the United States increased when compared to 2014 data, and this was the first increment since 2007. Major complications of prematurity and birth weight abnormalities are well known, but other complications including mental health abnormalities require more investigation to understand their association well. OBJECTIVES We aimed in this study to determine if prematurity and birth weight abnormalities including very low birth weight (VLBW) and low birth weight (LBW) are associated with depression among United States children aged between six and seventeen years old. DESIGN/METHODS This is a cross sectional study using data from the National Survey of Children’s Health (NSCH) 2011–2012. When we applied our selection criteria, 84,182 children out of the total 95,677 NSCH population were selected. Our exclusion criteria were: age less than six years, child’s history of cerebral palsy, and mental retardation. Multivariable logistic regression was done to control for confounding effects when studying the association of prematurity, birth weight abnormalities and depression. RESULTS Our results reveal that 3.6% of our population had history of depression, 11% were born prematurely, 7.4% had low birth weight, and 1.5% had very low birth weight. Depression was more frequent in children who were born prematurely (prevalence 4.3%) when compared to children born at term. Different models were built to analyze the association between prematurity, birth weight abnormalities and depression. There was no detectable statistically significant association when controlling for demographic data (age, gender, race, family structure) and mental health risk factors (parental poor mental health, chronic health conditions) as well as other factors. Results reveal that children who had chronic health conditions or had adverse family experiences have greater odds of having depression. On the other hand, African-American, male, and younger (6–11 years old) children have lower odds of depression. CONCLUSION Further longitudinal studies are required to establish a causal relationship of behavioral and psychological complications, and to determine the biological mechanisms of brain development that could be associated with depression among premature infants or those who have birth weight abnormalities.

Download Full-text