Cultural variation in factors associated with sudden infant death during sleep

Abstract Background Despite the significant reduction decades ago in sudden unexpected death in infancy (SUDI), decline of rates has slowed and stalled in some countries, including the USA. This led to an appreciation of ethnic variations in SUDI rates and the need to increase cultural sensitivity regarding sleep practices and circumstantial factors of SUDI. The study explored SUDI-related factors, in journal articles from two geo-cultural regions (Asian and Western countries), particularly for factors related to infant sleep practices. Methods A systematic review was conducted to identify SUDI-related factors in articles from PubMed, Scopus, and the Korean Citation Index from January 1992 to April 2019. From each article, SUDI-related factors were retrieved and categorized through the identification, aggregation, and categorization of factors into the areas of the triple risk model (TRM) of SUDI by their meanings and commonality. Significant trends in the frequency of factors were analyzed across time and between the two geo-cultural regions (Asian and Western countries) of article. Results From a review of 218 articles (38 Asian and 180 Western articles), 84 SUDI-related factors were identified: 39 factors for TRM 1, 44 factors for TRM 2, and one factor for TRM 3. Four of the top-ranked 10 factors were found in both cultural zones: sleep position, male sex, bed-sharing, and genetics. Both cultural zones identified sleep position (44.0%), bed-sharing (22.0%), and rooming-in (16.5%) as the three most important sleep-related factors for SUDI. Variations between the cultural zones were observed in the place of SUDI occurrence, overheating, swaddling or bedding standards, and smoking. Conclusions Regardless of the urgent need to identify SUDI-related factors in low-SUDI societies, Asian cultures showed a significant lack of articles on SUDI. Several sociocultural issues were recognized such as the meaning of bed-sharing and rooming-in, along with residential styles and traditional health beliefs on sleep-related SUDI factors. Particularly little attention towards smoking was found in Asian articles in terms of frequency, suggesting the need to enhance SUDI reduction strategies by incorporating gender-sensitive smoking cessation interventions. This review of SUDI factors requests child health professionals to be alert to sociocultural variations in sleep practices and SUDI factors.

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Sudden infant death syndrome (SIDS) and the routine otoacoustic emission infant hearing screening test: an epidemiological retrospective case–control study

BMJ Open ◽

10.1136/bmjopen-2019-030026 ◽

2019 ◽

Vol 9 (7) ◽

pp. e030026 ◽

Cited By ~ 1

Author(s):

Peter S Blair ◽

Daniel Rubens ◽

Anna Pease ◽

Diane Mellers ◽

Jenny Ingram ◽

...

Keyword(s):

Case Control Study ◽

Otoacoustic Emission ◽

Sudden Infant Death ◽

Case Control ◽

Sudden Infant ◽

Unexpected Death ◽

Retrospective Case ◽

Bed Sharing ◽

The Right ◽

Control Study

ObjectivesTo investigate whether decreased otoacoustic emission (OAE) signal recordings in the right ear are associated with an increased risk of sudden infant death syndrome (SIDS) and to monitor any temporal changes in risk factors.DesignRetrospective case–control study.SettingTelephone interviews with families recruited in England between July 2016 and October 2017 who experienced the unexpected death of a child <4 years old since 2008 and control families recruited from maternity wards in Bristol and Birmingham.ParticipantsWe recruited 91 (89%) of the 102 bereaved families who made initial contact, 64 deaths were under 1 year (sudden unexpected death in infancy) of which 60 remained unexplained (SIDS). Of the 220 control families, 194 (88%) follow-up interviews were conducted. We had analysable hearing data for 24 SIDS infants (40%) and 98 controls (51%).ResultsOAE signals were marginally increased rather than decreased among SIDS infants for the right ear, especially at lower frequencies, but not significantly so. The strongest predictors of SIDS were bed-sharing in hazardous (infant sleeping next to a carer who smoked, drank alcohol or slept on a sofa) circumstances (35% vs 3% controls, p<0.0001), infants found prone (33% vs 3% controls, p<0.0001) and infants whose health in the final week was ‘not good’ (53% vs 9% controls, p<0.0001). The prevalence of maternal smoking during pregnancy among both SIDS mothers (20%) and controls (10%) was much lower than previous studies.ConclusionsHearing data were difficult to obtain; larger numbers would be needed to determine if asymmetrical differences between the right and left ear were a marker for SIDS. A national prospective registry for monitoring and a renewed campaign to a new generation of parents needs to be considered underlining the initial message to place infants on their backs for sleep and the more recent message to avoid bed-sharing in hazardous circumstances.

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Association Between Sudden Infant Death Syndrome and Prone Sleep Position, Bed Sharing, and Sleeping Outside an Infant Crib in Alaska

PEDIATRICS ◽

10.1542/peds.108.4.923 ◽

2001 ◽

Vol 108 (4) ◽

pp. 923-927 ◽

Cited By ~ 20

Author(s):

B. D. Gessner ◽

G. C. Ives ◽

K. A. Perham-Hester

Keyword(s):

Sudden Infant Death Syndrome ◽

Infant Death ◽

Sudden Infant Death ◽

Sleep Position ◽

Sudden Infant ◽

Bed Sharing

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Sleep position and bed-sharing in sudden infant deaths: An examination of autopsy findings

The Journal of Pediatrics ◽

10.1067/mpd.2001.110327 ◽

2001 ◽

Vol 138 (2) ◽

pp. 212-217 ◽

Cited By ~ 19

Author(s):

Jon R. Thogmartin ◽

Charles F. Siebert ◽

William A. Pellan

Keyword(s):

Sleep Position ◽

Sudden Infant ◽

Infant Deaths ◽

Bed Sharing ◽

Autopsy Findings

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Sleep position and the use of soft bedding during bed sharing among African American infants at increased risk for sudden infant death syndrome

The Journal of Pediatrics ◽

10.1067/mpd.2001.111428 ◽

2001 ◽

Vol 138 (3) ◽

pp. 338-343 ◽

Cited By ~ 37

Author(s):

Louise Flick ◽

Deborah K. White ◽

Caroline Vemulapalli ◽

Barbara B. Stulac ◽

James S. Kemp

Keyword(s):

African American ◽

Sudden Infant Death Syndrome ◽

Infant Death ◽

Sudden Infant Death ◽

Sleep Position ◽

Sudden Infant ◽

Bed Sharing ◽

Increased Risk

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Neuropathological Developments in Sudden Infant Death Syndrome

Pediatric and Developmental Pathology ◽

10.1177/1093526618776439 ◽

2018 ◽

Vol 21 (6) ◽

pp. 515-521 ◽

Cited By ~ 3

Author(s):

Fiona M Bright ◽

Robert Vink ◽

Roger W Byard

Keyword(s):

Sudden Infant Death Syndrome ◽

Infant Death ◽

Risk Model ◽

Sudden Infant Death ◽

Reproducible Research ◽

Sudden Infant ◽

Unexpected Death ◽

Integrated Network ◽

Neurokinin 1 ◽

Medullary Nuclei

A wide variety of neuropathological abnormalities have been investigated in infants who have died of sudden infant death syndrome (SIDS). Issues which detracted from early studies included failure to use uniform definitions of SIDS and lack of appropriately matched control populations. Development of the triple risk model focused attention on the concept of an inherent susceptibility to unexpected death in certain infants, with research demonstrating a role for the neurotransmitter serotonin within the brainstem. However, it now appears that neuropathological abnormalities in SIDS infants are more complex than a simple serotonergic deficiency in certain medullary nuclei but instead could involve failure of an integrated network of neurochemical transmitters in a variety of subcortical locations. The following overview examines recent research developments looking particularly at the potential role of the peptide neurotransmitter substance P and its neurokinin-1 receptor in multiple nuclei within the brainstem, asymmetry and microdysgenesis of the hippocampus, and decreased orexin levels within dorsomedial, perifornical, and lateral levels in the hypothalamus. Whether such research will lead to identifiable biomarker for infants at risk of SIDS is yet to be established. Use of standardized and consistent methods of classifying and categorizing infant deaths will be pivotal in generating reproducible research results.

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Renewed Attention Needed for Prevention of Sudden Unexpected Death in Infancy in the Netherlands

Frontiers in Pediatrics ◽

10.3389/fped.2021.757530 ◽

2021 ◽

Vol 9 ◽

Author(s):

Floortje Kanits ◽

Monique P. L'Hoir ◽

Magda M. Boere-Boonekamp ◽

Adèle C. Engelberts ◽

Edith J. M. Feskens

Keyword(s):

The Netherlands ◽

Risk Groups ◽

Infant Care ◽

Developed Countries ◽

Sudden Unexpected Death ◽

Sudden Infant ◽

Unexpected Death ◽

Sleeping Position ◽

Smoking During Pregnancy ◽

Bed Sharing

Background: The incidence of sudden unexpected death in infancy (SUDI), which includes sudden infant death syndrome (SIDS), has declined in developed countries since the 1980s, including the Netherlands. To identify improvement opportunities in SUDI prevention, we monitored the adherence of parents to the prevention advice on infant care habits over the past 20 years, especially in relation to the SUDI incidence over time. Potential changes in parental adherence between the latest surveys are of specific interest, as these indicate where current focus is needed.Methods: Description of the prevalence of infant care factors related to the risk of SUDI, assessed from five Dutch national surveys from 1999 to 2017 among parents of infants under 12 months, and analysis of the potential differences in these prevalences between the two latest surveys in 2010/11 and 2017 with a z-test.Results: Supine sleeping position decreased from the highest prevalence of 92% in 2010/11, to 83% in 2017. Sleep sack use has increased to 55%, the highest prevalence up to now. Avoiding a duvet has remained reasonably stable since 2002/03 and now 95% of parents do not use a duvet. The prevalence of room-sharing, without sharing the bed, increased from 14% in 1999 to the highest prevalence in 2017 (31%). However, also bed-sharing almost doubled from 5.6% in 2010/11 to 10% in 2017. Breastfeeding decreased between 1999 and 2010/11, but increased from 34% in 2010/11 to 42% in 2017. An increased prevalence of mothers who abstained from smoking during pregnancy, as well as both parents not smoking, was observed, although mostly higher educated parents showed this beneficial behavior.Discussion and Conclusion: Much has already been achieved first by decreasing prone sleeping since the 80's, and subsequently promoting supine as the safest sleep position. The decrease in duvet use and smoking, and an increase in breastfeeding have also had impact. Indications of a recent decreased prevalence of the supine sleeping position and higher prevalence of bed-sharing might relate to the slightly increasing SUDI incidence in the Netherlands. Renewed attention for prevention of SUDI and specific advice targeting high-risk groups is needed. Modern, picture driven information via internet is recommended.

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Ten Percent of SIDS Cases are Murder — or are They?

Academic Forensic Pathology ◽

10.23907/2017.018 ◽

2017 ◽

Vol 7 (2) ◽

pp. 163-170 ◽

Cited By ~ 2

Author(s):

Christopher M. Milroy ◽

Charis Kepron

Keyword(s):

Sudden Infant Death ◽

Current Data ◽

Multilevel Pathways of Colorectal Cancer Screening Among Low-Income Vietnamese Americans: A Structural Equation Modeling Analysis

Cancer Control ◽

10.1177/10732748211011077 ◽

2021 ◽

Vol 28 ◽

pp. 107327482110110

Author(s):

Grace X. Ma ◽

Lin Zhu ◽

Timmy R. Lin ◽

Yin Tan ◽

Phuong Do

Keyword(s):

Health Beliefs ◽

Low Income ◽

Self Efficacy ◽

Limited English Proficiency ◽

Structural Equation ◽

Vietnamese Americans ◽

Equation Modeling ◽

Community Based ◽

Related Factors ◽

Crc Screening

Background: Colorectal cancer (CRC) disproportionately affects Vietnamese Americans, especially those with low income and were born outside of the United States. CRC screening tests are crucial for prevention and early detection. Despite the availability of noninvasive, simple-to-conduct tests, CRC screening rates in Asian Americans, particularly Vietnamese Americans, remain suboptimal. The purpose of this study was to evaluate the interplay of multilevel factors – individual, interpersonal, and community – on CRC screening behaviors among low-income Vietnamese Americans with limited English proficiency. Methods: This study is based on the Sociocultural Health Behavior Model, a research-based model that incorporates 6 factors associated with decision-making and health-seeking behaviors that result in health care utilization. Using a community-based participatory research approach, we recruited 801 Vietnamese Americans from community-based organizations. We administered a survey to collect information on sociodemographic characteristics, health-related factors, and CRC screening-related factors. We used structural equation modeling (SEM) to identify direct and indirect predictors of lifetime CRC screening. Results: Bivariate analysis revealed that a greater number of respondents who never screened for CRC reported limited English proficiency, fewer years of US residency, and lower self-efficacy related to CRC screening. The SEM model identified self-efficacy (coefficient = 0.092, P < .01) as the only direct predictor of lifetime CRC screening. Educational attainment (coefficient = 0.13, P < .01) and health beliefs (coefficient = 0.040, P < .001) had a modest significant positive relationship with self-efficacy. Health beliefs (coefficient = 0.13, P < .001) and educational attainment (coefficient = 0.16, P < .01) had significant positive relationships with CRC knowledge. Conclusions: To increase CRC screening uptake in medically underserved Vietnamese American populations, public health interventions should aim to increase community members’ confidence in their abilities to screen for CRC and to navigate associated processes, including screening preparation, discussions with doctors, and emotional complications.

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Aquaporin-1 and aquaporin-9 gene variations in sudden infant death syndrome

International Journal of Legal Medicine ◽

10.1007/s00414-020-02493-9 ◽

2021 ◽

Author(s):

Siri Hauge Opdal ◽

Linda Ferrante ◽

Torleiv Ole Rognum ◽

Arne Stray-Pedersen

Keyword(s):

Sudden Infant Death Syndrome ◽

Infant Death ◽

Brain Function ◽

Sudden Infant Death ◽

Sudden Infant ◽

Unexpected Death ◽

Aquaporin 9 ◽

Genes Encoding ◽

External Risk ◽

The Brain

AbstractSeveral studies have indicated that a vulnerability in the development and regulation of brain function is involved in sudden infant death syndrome (SIDS). The aim of this study was to investigate the genes encoding the brain aquaporins (AQPs) AQP1 and AQP9 in SIDS. The hypothesis was that specific variants of these genes are part of the genetic vulnerability predisposing infants to sudden unexpected death. The study included 168 SIDS cases with a median age of 15.5 (range 2–52) weeks and 372 adolescent/adult deceased controls with a median age of 44 (range 11–91) years. In the AQP1 gene, the rs17159702 CC/CT genotypes were found to be associated with SIDS (p = 0.02). In the AQP9 gene, the combination of a TT genotype of rs8042354, rs2292711 and rs13329178 was more frequent in SIDS cases than in controls (p = 0.03). In the SIDS group, an association was found between genetic variations in the AQP1 gene and maternal smoking and between the 3xTT combination in the AQP9 gene and being found lifeless in a prone position. In conclusion, this study adds further evidence to the involvement of brain aquaporins in SIDS, suggesting that specific variants of AQP genes constitute a genetic predisposition, making the infant vulnerable to sudden death together with external risk factors and probably other genetic factors.

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Marked progress in AL amyloidosis survival: a 40-year longitudinal natural history study

Blood Cancer Journal ◽

10.1038/s41408-021-00529-w ◽

2021 ◽

Vol 11 (8) ◽

Author(s):

Andrew Staron ◽

Luke Zheng ◽

Gheorghe Doros ◽

Lawreen H. Connors ◽

Lisa M. Mendelson ◽

...

Keyword(s):

Standards Of Care ◽

Al Amyloidosis ◽

Unexpected Death ◽

Related Factors ◽

Term Survival ◽

Natural History Study ◽

Boston University ◽

Disease Outcomes ◽

Patient Subgroups ◽

Over Time

AbstractThe recent decades have ushered in considerable advancements in the diagnosis and treatment of systemic light chain (AL) amyloidosis. As disease outcomes improve, AL amyloidosis-unrelated factors may impact mortality. In this study, we evaluated survival trends and primary causes of death among 2337 individuals with AL amyloidosis referred to the Boston University Amyloidosis Center. Outcomes were analyzed according to date of diagnosis: 1980-1989 (era 1), 1990-1999 (era 2), 2000-2009 (era 3), and 2010-2019 (era 4). Overall survival increased steadily with median values of 1.4, 2.6, 3.3, and 4.6 years for eras 1–4, respectively (P < 0.001). Six-month mortality decreased over time from 23% to 13%. Wide gaps in survival persisted amid patient subgroups; those with age at diagnosis ≥70 years had marginal improvements over time. Most deaths were attributable to disease-related factors, with cardiac failure (32%) and sudden unexpected death (23%) being the leading causes. AL amyloidosis-unrelated mortality increased across eras (from 3% to 16% of deaths) and with longer-term survival (29% of deaths occurring >10 years after diagnosis). Under changing standards of care, survival improved and early mortality declined over the last 40 years. These findings support a more optimistic outlook for patients with AL amyloidosis.

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