scholarly journals Interactive effects of maternal cigarette smoke, heat stress, hypoxia, and lipopolysaccharide on neonatal cardiorespiratory and cytokine responses

2016 ◽  
Vol 311 (6) ◽  
pp. R1113-R1124 ◽  
Author(s):  
Fiona B. McDonald ◽  
Kumaran Chandrasekharan ◽  
Richard J. A. Wilson ◽  
Shabih U. Hasan

Maternal cigarette smoke (CS) exposure exhibits a strong epidemiological association with Sudden Infant Death Syndrome, but other environmental stressors, including infection, hyperthermia, and hypoxia, have also been postulated as important risk factors. This study examines whether maternal CS exposure causes maladaptations within homeostatic control networks by influencing the response to lipopolysaccharide, heat stress, and/or hypoxia in neonatal rats. Pregnant dams were exposed to CS or parallel sham treatments daily for the length of gestation. Offspring were studied at postnatal days 6–8 at ambient temperatures (Ta) of 33°C or 38°C. Within each group, rats were allocated to control, saline, or LPS (200 µg/kg) treatments. Cardiorespiratory patterns were examined using head-out plethysmography and ECG surface electrodes during normoxia and hypoxia (10% O2). Serum cytokine concentrations were quantified from samples taken at the end of each experiment. Our results suggest maternal CS exposure does not alter minute ventilation (V̇e) or heart rate (HR) response to infection or high temperature, but independently increases apnea frequency. CS also primes the inflammatory system to elicit a stronger cytokine response to bacterial insult. High Ta independently depresses V̇e but augments the hypoxia-induced increase in V̇e. Moreover, higher Ta increases HR during normoxia and hypoxia, and in the presence of an immune challenge, increases HR during normoxia, and reduces the increase normally associated with hypoxia. Thus, while most environmental risk factors increase the burden on the cardiorespiratory system in early life, hyperthermia and infection blunt the normal HR response to hypoxia, and gestational CS independently destabilizes breathing by increasing apneas.


PEDIATRICS ◽  
1994 ◽  
Vol 94 (1) ◽  
pp. 105-107
Author(s):  
Carl E. Hunt

I fully support a comprehensive professional and public intervention campaign in the US to establish supine as the standard sleep position. Although other preventive health objectives can be included, the emphasis needs to be clearly focused on sleep position. Achieving the lowest possible prone prevalence rate in the US is thus the first goal of this new campaign. The second and equally important goal of the new campaign should be to utilize this opportunity to maximum advantage to enhance our knowledge regarding the epidemiological risk factors causally related to SIDS and their interactions, and the interactions between epidemiological and biological risk factors. In addition to quantifying changes in infant mortality and in infant sleep position, we will also need to characterize both the supine and the persistent prone infant groups in regard to all of the putative epidemiological risk factors for SIDS. This campaign can thus enhance our understanding of the epidemiological risk factors for SIDS as long as a significant decrease in prone prevalence can be achieved.



2017 ◽  
Vol 7 (2) ◽  
pp. 200-211 ◽  
Author(s):  
Evan W. Matshes ◽  
Emma O. Lew

Recent evidence indicates that with thorough, high quality death investigations and autopsies, forensic pathologists have recognized that many unexpected infant deaths are, in fact, asphyxial in nature. With this recognition has come a commensurate decrease in, and in some cases, abolition of, the label “sudden infant death syndrome” (SIDS). Current controversies often pertain to how and why some infant deaths are determined to be asphyxial in nature and whether or not apparent asphyxial circumstances are risk factors for SIDS, or rather, harbingers of asphyxial deaths. In an effort to sidestep these controversies, some forensic pathologists elected to instead use the noncommittal label “sudden unexpected infant death” (SUID), leading to the unfortunate consequence of SUID – like SIDS – gaining notoriety as an actual disease that could be diagnosed, studied, and ultimately cured. Although it is not possible to provide death certification guidance for every conceivable type of unexpected infant death, we recognize and propose a simple classification system for overarching themes that cover the vast majority of cases where infants die suddenly and unexpectedly.



10.1186/gm207 ◽  
2010 ◽  
Vol 2 (11) ◽  
pp. 86 ◽  
Author(s):  
David W Van Norstrand ◽  
Michael J Ackerman


PEDIATRICS ◽  
1997 ◽  
Vol 100 (5) ◽  
pp. 835-840 ◽  
Author(s):  
E. A. Mitchell ◽  
P. G. Tuohy ◽  
J. M. Brunt ◽  
J. M. D. Thompson ◽  
M. S. Clements ◽  
...  


PEDIATRICS ◽  
1984 ◽  
Vol 73 (5) ◽  
pp. 652-655
Author(s):  
Jonathan M. Couriel ◽  
Anthony Olinsky

The ventilatory response to acute hypercapnia was studied in 68 parents of victims of sudden infant death syndrome and 56 control subjects. Tidal volume, inspiratory time, and total respiratory cycle time were measured before and immediately after a vital capacity breath of 13% CO2 in oxygen. Instantaneous minute ventilation, mean inspiratory flow (tidal volume/inspiratory time), and respiratory timing (inspiratory time/total respiratory cycle time) were calculated. Both groups of subjects showed a marked increase in tidal volume (48.4% ± 26.5%), instantaneous minute ventilation (56% ± 35%), and tidal volume/inspiratory time (56.8% ± 33.5%) after inhalation of the test gas, with little change in inspiratory time/total respiratory cycle time. There were no significant differences between the two groups for ventilation before or after inhalation of the test gas. The ventilatory response to acute hypercapnia is mediated by the peripheral chemoreceptors. These results suggest that an inherited abnormality of peripheral chemoreceptor function is unlikely to be a factor leading to sudden infant death syndrome.



2021 ◽  
Author(s):  
Dennis Storz ◽  
Christof Dame ◽  
Anke Wendt ◽  
Alexander Gratopp ◽  
Christoph Bührer

Sudden unexpected death in infancy (SUDI), previously termed sudden infant death syndrome (SIDS), is the second leading cause of death in infants beyond the neonatal period in Germany, and a major cause of infant mortality in economically well developed countries (OECD Health Statistics, 2019). The risk of SUDI peaks at the age of 2–4 months and then decreases continuously till the end of the first year. A complex multifactorial cause, rather than a single characteristic factor, may cause SUDI within a critical period of infant development (Guntheroth WG et al., Pediatrics 2002; 110: e64–e64). Risk factors include prematurity, male gender, bottle-feeding, prone sleeping position, overheating, as well as exposure to smoke amongst others (Carpenter RG et al., Lancet 2004; 363: 185–191). Thus, health professionals consistently advise and educate parents about avoidable risk factors of SUDI at routine well-baby examinations. Since the advent of SUDI prevention strategies in the 1980s, the incidence has decreased 10fold, from 1,55/1.000 live births in 1991 to 0,15/1000 in 2015. This number seems to have reached a steady state (Statistisches Bundesamt Germany, 2015).



2007 ◽  
Vol 21 (2) ◽  
pp. 158-164 ◽  
Author(s):  
Linda Esposito ◽  
Thomas Hegyi ◽  
Barbara M. Ostfeld


Author(s):  
Ian Mitchell ◽  
Daniel Y Wang ◽  
Christine Troskie ◽  
Lisa Loczy ◽  
Abby Li ◽  
...  

Abstract Objectives Risk factors for sudden infant death syndrome include premature birth, maternal smoking, prone or side sleeping position, sleeping with blankets, sharing a sleeping surface with an adult, and sleeping without an adult in the room. In this study, we compare parents’ responses on sleep patterns in premature and term infants with medical complexity. Methods Parents of children enrolled in the Canadian Respiratory Syncytial Virus Evaluation Study of Palivizumab were phoned monthly regarding their child’s health status until the end of each respiratory syncytial virus season. Baseline data were obtained on patient demographics, medical history, and neonatal course. Responses on adherence to safe sleep recommendations were recorded as part of the assessment. Results A total of 2,526 preterms and 670 term infants with medical complexity were enrolled. Statistically significant differences were found in maternal smoking rates between the two groups: 13.3% (preterm); 9.3% (term) infants (χ 2=8.1, df=1, P=0.004) and with respect to toys in the crib: 12.3% (term) versus 5.8% preterms (χ 2=24.5, df=1, P<0.0005). Preterm infants were also significantly more likely to be placed prone to sleep (8.8%), compared with term infants (3.3%), (χ 2=18.1, df=1, P<0.0005). Conclusion All the infants in this study had frequent medical contacts. There is a greater prevalence of some risk factors for sudden infant death syndrome in preterm infants compared to term infants with medical complexity. Specific educational interventions for vulnerable infants may be necessary.



PEDIATRICS ◽  
1997 ◽  
Vol 100 (4) ◽  
pp. 613-621 ◽  
Author(s):  
N. Oyen ◽  
T. Markestad ◽  
L. M Irgens ◽  
K. Helweg-Larsen ◽  
B. Alm ◽  
...  


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