scholarly journals The Influence of Increased Survival in Very Low Birth Weight (VLBW), Low Birth Weight (LBW) and Normal Birth Weight (NBW) Infants on the Incidence of Sudden Infant Death Syndrome (SIDS): 1985-1991. † 1134

1997 ◽  
Vol 41 ◽  
pp. 191-191
Author(s):  
Harold R. Bigger ◽  
Jean M. Silvestri ◽  
Susan Shott ◽  
Debra E. Weese-Mayer
PEDIATRICS ◽  
1990 ◽  
Vol 86 (2) ◽  
pp. 176-183
Author(s):  
Catherine Dollfus ◽  
Michael Patetta ◽  
Earl Siegel ◽  
Alan W. Cross

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.


2004 ◽  
Vol 16 (2) ◽  
pp. 154
Author(s):  
M.R. Park ◽  
S.K. Cho ◽  
J.Y. Park ◽  
K.M. Kim ◽  
Y.J. Choi ◽  
...  

In this study, we investigated the relationship between the sex of cloned pigs and sudden infant death syndrome (SIDS). Three cell lines (2 male and 1 female) were obtained from F1 fetuses derived from 3 different dams (Yorkshire) inseminated by the same sire (Landrace); one female fibroblast cell line was obtained from a Duroc-strain fetus acquired from a slaughterhouse, the age of the fetus unknown. The fetal fibroblast cells were cultured in DMEM supplemented with 10% fetal bovine serum under 5% CO2 in air at 37°C. For NT, we used the 4 cell lines described above. All 37 cloned piglets derived from 10 pregnant recipients were alive at term and began breathing readily. Of those piglets born, 18/22 males and 5/15 females died within 2 months of age. A total of 350 paraffin blocks from 18 deceased cloned male piglets and 90 paraffin blocks from six age-matched normal control piglets were prepared from the midbrain, medulla oblongata, liver, lung, kidney, spleen, small and large intestine, thymus, uterus, placenta, ovary, testis, skin, and skeletal muscle. We found that the birth weights of male clones were 57% lower than those of control age- and sex-matched piglets. Piglets with low birth weight (<900g) had more than twice the risk of SIDS relative to those piglets weighing more than 1000g. The low birth weights of the cloned male piglets (0.84±0.05kg) were not merely an artifact, as the average birth weights of cloned female piglets (1.47±0.09kg) were not lower than weights of piglets produced by AI-derived control female piglets (1.36±0.12kg). An initial examination of brain samples from 18 cloned male piglets that died soon after birth identified seven piglets with meningitis characterized by severe neutrophilic inflammation in the temporal brain lobes (38.8%, 7/18). We verified meningitis when more than 1000 neutrophils were counted per cubic millimeter of tissue. Next, we found hepatopneumonic congestion (16.6%, 3/18). The deceased male clones with meningitis showed extensive neuronal cell death and blood-brain barrier damage, whereas cloned piglets with congestion had fewer and larger alveolar air sacs. Extensive alveolar cell death, especially of pneumocytes and the bronchial epithelium, was confirmed by TUNEL assay. Lung and liver congestion may be caused by a slowly flowing blood stream from heart, resulting in CO2 and O2 exchange problems. Although the gross anatomy of the cloned male piglets was normal, they were associated with other severe handicaps, the commonest being leg abnormality which occurred in 33% (6/18) of dead male cloned piglets followed by Leydig cell hypoplasia and short face. Even though 4 of 41 AI-derived control piglets died within 1 week after birth, we could not find any anomalies in them. Thus, the present study suggests that our data might reflect sex difference but not cell type difference, and that death of the cloned male piglets might be caused by risk factors of sudden infant death syndrome such as low birth weight and multiple organ failure in conjunction with hepatopneumonic congestion and cerebromeningitis.


2020 ◽  
Vol 11 ◽  
Author(s):  
Jessica Blackburn ◽  
Valeria F. Chapur ◽  
Julie A. Stephens ◽  
Jing Zhao ◽  
Anne Shepler ◽  
...  

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.


PEDIATRICS ◽  
1993 ◽  
Vol 91 (1) ◽  
pp. 106-112
Author(s):  
Joel E. Haas ◽  
James A. Taylor ◽  
Abraham B. Bergman ◽  
Gerald van Belle ◽  
Judy L. Felgenhauer ◽  
...  

The risk of sudden infant death syndrome (SIDS) is said to be enhanced by factors such as prematurity, low birth weight, and perinatal distress. The significance of risk factors for SIDS research was questioned because the majority of SIDS victims seem to lack them. Therefore, postmortem records of 1144 infants who died suddenly and unexpectedly in King County, Washington, over a 25-year period were studied. Deaths were classified as "explained" if a cause was apparent, "classic" SIDS if the history and autopsy were unrevealing or, where the diagnosis of SIDS was doubtful, as "probable" or "possible" SIDS. The infants' birth certificates were compared with those of 3647 infants born during a similar period. Seventy-nine deaths (7%) were explained. The 1065 previously certified as SIDS were reclassified classic SIDS (82%), probable SIDS (13%), and possible SIDS (5%). Low birth weight, small size for gestational age, prematurity, and low 5-minute Apgar scores each form a "continuum"; the possible-SIDS group had the highest proportion of such infants, followed by the probable- and classic-SIDS groups, which exhibit extensive overlap with the control population. A 5-minute Apgar score of less than 7 and delayed postnatal growth rate are not risk factors for classic SIDS. Risk factors are more prevalent in SIDS infants where the diagnosis may be doubtful. The great majority of SIDS victims possess fewer risk factors. To avoid the bias of confounding variables, SIDS research should focus on as "pure" a SIDS population as is possible.


PEDIATRICS ◽  
1982 ◽  
Vol 69 (3) ◽  
pp. 301-304 ◽  
Author(s):  
Joseph Werthammer ◽  
Elizabeth R. Brown ◽  
Raymond K. Neff ◽  
H. William Taeusch

The association between bronchopulmonary dysplasia and sudden infant death syndrome was studied retrospectively in low-birth-weight infants discharged from the neonatal program at Harvard Medical School. The incidence of sudden infant death syndrome was seven times greater in infants with bronchopulmonary dysplasia when compared with a group of control infants without bronchopulrnonary dysplasia. Confounding factors, including birth weight, sex, multiple birth, socioeconomic status, and apnea were evaluated. The results indicate that there is an association between bronchopulmonary dysplasia and sudden infant death syndrome.


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