Chronic Fetal Hypoxia and Sudden Infant Death Syndrome: Interaction Between Maternal Smoking and Low Hematocrit During Pregnancy

PEDIATRICS ◽  
1990 ◽  
Vol 86 (4) ◽  
pp. 535-540
Author(s):  
Marc G. Bulterys ◽  
Sander Greenland ◽  
Jess F. Kraus
Keyword(s):  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Sudden Infant Death ◽  
Sudden Infant ◽  
First Year ◽  
Fetal Hypoxia ◽  
Maternal Cigarette Smoking ◽  
Increased Risk ◽  
The Us ◽  
First Year Of Life

To investigate the hypothesis that chronic fetal hypoxia contributes to the etiology of sudden infant death syndrome (SIDS), a possible interaction between the effect of maternal cigarette smoking and low hematocrit during pregnancy on the risk of SIDS was studied using the US Collaborative Perinatal Project cohort. The 193 SIDS cases identified in the cohort were analyzed with 1930 controls randomly selected from infants who survived the first year of life. After adjustment for maternal age, infants born to mothers who smoked 10 or more cigarettes per day and who were anemic (hematocrit less than 30%) during pregnancy were at a much higher risk of SIDS than infants born to mothers who did not smoke and were not anemic (odds ratio = 4.0; 95% confidence limits, 2.1 and 7.4). Smoking 10 or more cigarettes per day vs none increased the risk of SIDS by 70% among women with hematocrit at or above 30% but increased risk threefold among women with hematocrit below 30%. After adjustment for more potential confounders in a logistic regression model, the effect of smoking on SIDS continued to increase with lower levels of hematocrit during pregnancy. Birth weight accounted for very little of these associations. Low hematocrit was not a risk factor for SIDS among nonsmokers but became an important predictor among heavy smokers. These findings are in agreement with the hypothesis that chronic fetal hypoxia may predispose to SIDS, possibly by impairing the normal development of the fetal central nervous system.

Sudden Infant Death Syndrome in a Twin: A Comparison of Sibling Histories

PEDIATRICS ◽  
1986 ◽  
Vol 78 (1) ◽  
pp. 146-150
Author(s):  
A. Kahn ◽  
D. Blum ◽  
M. F. Muller ◽  
L. Montauk ◽  
A. Bochner ◽  
...  
Keyword(s):  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Sudden Infant Death ◽  
Clinical Risk Factor ◽  
Control Group ◽  
Sudden Infant ◽  
First Year ◽  
Control Infant ◽  
The Mean ◽  
First Year Of Life

To determine possible characteristics of infant victims of sudden death, we examined 114 items related to the pre- and postnatal histories of 42 pairs of twins one of whom died of sudden infant death syndrome (SIDS) leaving a surviving sibling. Interviews with the parents were conducted after the occurrence of SIDS, and the data were checked with records held by gynecologists and pediatricians. To evaluate the specificity of any factors, we studied a control group of 42 age- and sex-matched pairs of twins, both of whom survived the first year of life. Only 11 of 114 characteristics were significantly related to SIDS: future victims had a smaller weight and height at birth, stayed longer in the nursery, and followed a moving object with their eyes, had head control, and smiled at a later age than their surviving siblings. They also fatigued more often during feeding (11/42) and had reduced arm and neck tonus (9/42). They were described as longer sleepers than their surviving siblings. During sleep, some SIDS twins, but no surviving twin, were found to be cyanotic at least once or pale (4/42) and were repeatedly covered with abundant sweat (8/42). In the control group of normal twins, the occurrence of most of these characteristics was found with a frequency comparable to that seen in the SIDS infants; the specificity of these characteristics is thus considered doubtful. The mean birth weight and height were significantly greater in the control group, and no control infant had an episode of cyanosis or pallor or repeated episodes of profuse sweating observed during their sleep. It is concluded that, if further research validates the occurrence of night hyperhydrosis in some future SIDS victims, this symptom could be a clinical risk factor.

Oculocardiac Reflex in Near Miss for Sudden Infant Death Syndrome Infants

PEDIATRICS ◽  
1983 ◽  
Vol 71 (1) ◽  
pp. 49-52 ◽  
Author(s):  
André Kahn ◽  
Jalil Riazi ◽  
Denise Blum
Keyword(s):  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Sudden Infant Death ◽  
Near Miss ◽  
Cardiac Response ◽  
Control Group ◽  
Sudden Infant ◽  
First Year ◽  
First Year Of Life

To gain insight into the role of the vagus nerve in sudden infant death syndrome (SIDS), 180 infants ranging in age from 1 to 66 weeks were examined with respect to cardiac response to ocular compression. There were 35 near-miss infants, 76 normal siblings of SIDS victims, and 69 normal control infants. Asystoles within the control group ranged from 0.3 to 1.8 seconds. Ten of 35 (28%) near-miss infants and 10/76 (13%) siblings had asystoles >2.0 seconds when first tested. When statistically compared, the near-miss infants were significantly different from both the control infants and the siblings (Kruskal-Wallis procedure: P < .01, and P < .05, respectively). It is concluded that in the first year of life a significant number of near-miss infants have an exaggerated cardiac response to ocular compression. Furthermore, the presence of prolonged asystoles in certain siblings indicates that vagal hypersensitivity, as manifested by ocular compression, may be, in part, hereditary.

scholarly journals Medical, Forensic and Social Quandaries of Sudden Infant Death Syndrome Today

2020 ◽  
Vol 11 (3sup1) ◽  
pp. 20-30
Author(s):  
Tatiana Iov ◽  
◽  
Cristina Furnică ◽  
Sofia Mihaela David ◽  
Diana Bulgaru-Iliescu ◽  
...  
Keyword(s):  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Causes Of Death ◽  
Clinical History ◽  
Sudden Infant Death ◽  
Sudden Infant ◽  
First Year ◽  
Forensic Investigation ◽  
Detailed Clinical History ◽  
First Year Of Life

Sudden Infant Death Syndrome (SIDS) is described as the sudden, unexplained death (with no attributable cause, during sleep) of a seemingly healthy child before reaching the first year of life. Statistically, SIDS is recognized today as a leading cause of death in infants aged 1 to 12 months. In the present article the authors have analyzed known risk factors, classifications and current standards of forensic investigation while highlighting the necessity of detailed clinical history, autopsy, scene of death examination and lab findings (radiology, metabolic anomalies, infectious diseases and toxicology) in SIDS diagnosis. For an infant death to be considered SIDS, all other possible causes of death must be first excluded, the diagnosis requiring detailed collection and analysis of antemortem patient data and a complete autopsy. Although the forensic methods of today are more exact, the distinction between SIDS and other causes of death (e.g. unintentional asphyxiation, infanticide) remains very difficult in some cases.

scholarly journals Toxigenic bacteria and sudden infant death syndrome (SIDS): nasopharyngeal flora during the first year of life

1999 ◽  
Vol 25 (1-2) ◽  
pp. 51-58 ◽  
Author(s):  
C.Caroline Blackwell ◽  
Doris A.C. MacKenzie ◽  
Valerie S. James ◽  
Robert A. Elton ◽  
Abdulaziz A. Zorgani ◽  
...  
Keyword(s):  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Sudden Infant Death ◽  
Sudden Infant ◽  
First Year ◽  
First Year Of Life

STUDIES OF THE SUDDEN INFANT DEATH SYNDROME IN KING COUNTY, WASHINGTON. III. EPIDEMIOLOGY

PEDIATRICS ◽  
1972 ◽  
Vol 49 (6) ◽  
pp. 860-870
Author(s):  
Abraham B. Bergman ◽  
C. George Ray ◽  
Margaret A. Pomeroy ◽  
Patricia W. Wahl ◽  
J. Bruce Beckwith
Keyword(s):  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Age Distribution ◽  
Birth Certificate ◽  
Sudden Infant Death ◽  
Sudden Infant ◽  
First Year ◽  
King County ◽  
Upper Respiratory Infection ◽  
First Year Of Life

Excluding the first week of life, sudden infant death syndrome (SIDS) is the greatest single cause of death during the first year of life and second only to accidents as the greatest killer of children under age 15. All cases of SIDS occurring in King County, Washington (170) during a 44-month period were studied. Birth certificate data from all children born in the county during the same period were utilized for comparison. Findings include a characteristic age distribution (peak at 2 to 3 months), preponderance in males, low birth weight babies, and in lower socioeconomic class families. "Seasonality" and apparent "time clustering" were present in the infants. All SIDS infants died during sleep in a silent fashion. Forty-four percent of the babies had an upper respiratory infection in the 2-week period prior to death. The epidemiologic findings point to viral infection as playing a major contributory role in SIDS.

Increased Muscularity of the Pulmonary Circulation in Victims of Sudden Infant Death Syndrome

PEDIATRICS ◽  
1979 ◽  
Vol 63 (1) ◽  
pp. 18-23 ◽  
Author(s):  
Adrian Williams ◽  
Gordon Vawter ◽  
Lynne Reid
Keyword(s):  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Pulmonary Circulation ◽  
Sudden Infant Death ◽  
Medial Wall ◽  
Sudden Infant ◽  
First Year ◽  
Structural Alterations ◽  
First Year Of Life ◽  
Inflated Lung

It has recently become apparent that some victims of sudden infant death synclrome (SIDS) are chronically hypoxemic before death. In this study, the structural alterations in the pulmonary circulation of 15 victims of SIDS were examined using precise quantitative morphometric techniques applied to the injected and inflated lung. Increased muscularity of the pulmonary circulation has been demonstrated, as evidenced by the extension of muscle into arteries not usually muscularized during the first year of life, and by an increased thickness of the medial wall in some patients. This confirms the findings of Naeye and further justifies the shift of investigative efforts from the events immediately surrounding death to a search for chronic abnormalities.

scholarly journals Association between monoamine oxidase A promoter polymorphism and the risk of sudden infant death syndrome: a meta-analysis

2021 ◽  
Author(s):  
Qiaoxia Zhou ◽  
Daoyin Gong ◽  
Yu Zhang ◽  
Feijun Huang
Keyword(s):  
Monoamine Oxidase ◽  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Protective Factor ◽  
Meta Analysis ◽  
Variable Number Tandem Repeat ◽  
Sudden Infant Death ◽  
Monoamine Oxidase A ◽  
Sudden Infant ◽  
Increased Risk

Abstract Introduction The etiology of sudden infant death syndrome (SIDS) remains an unsolved problem. The aim of this meta-analysis is to investigate the potential association between monoamine oxidase A (MAOA) promoter variable number tandem repeat (VNTR) polymorphism and SIDS risk. Methods A systematic review and meta-analysis were conducted on studies from accessible electronic databases. Each VNTR variant was examined in each gender independently by comparing with the pooled results of other alleles. Results A total of six independent case–control studies including 1022 SIDS cases and 1839 controls were enrolled in this meta-analysis. In both of the whole populations and Caucasian populations, male infants with the low-MAOA-expression alleles (2R+3R) were found to exhibit a statistically significant increased risk of SIDS, whereas those with a 4R allele exhibited a reduced risk of SIDS. Besides, an increased risk of SIDS was detected in male Caucasian infants with 2R or 3R alleles. However, none of the allele or genotype variants was associated with SIDS in female victims. Conclusion In male Caucasian infants, the low expression of MAOA promoter VNTR alleles (2R and 3R) is associated with an increased risk of SIDS, and the existence of the 4R allele could be regarded as a protective factor.

Smoking and the Sudden Infant Death Syndrome

PEDIATRICS ◽  
1993 ◽  
Vol 91 (5) ◽  
pp. 893-896 ◽  
Author(s):  
E. A. Mitchell ◽  
R. P. K. Ford ◽  
A. W. Stewart ◽  
B. J. Taylor ◽  
D. M. O. Becroft ◽  
...  
Keyword(s):  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Maternal Smoking ◽  
Sudden Infant Death ◽  
Sudden Infant ◽  
Risk Of Death ◽  
Increased Risk ◽  
Wide Range ◽  
Household Members ◽  
Control Study

Objective. Maternal smoking has been shown to be a risk factor for sudden infant death syndrome (SIDS). The effect of smoking by the father and other household members has not previously been examined. Methods. A large nationwide case-control study. Four hundred eighty-five SIDS deaths in the postneonatal age group were compared with 1800 control infants. Results. Infants of mothers who smoked during pregnancy had a 4.09 (95% confidence interval [CI] = 3.28, 5.11) greater risk of death than infants of mothers who did not smoke. Infants of mothers who smoked postnatally also had an increased risk of SIDS compared with infants of nonsmokers and, furthermore, the risk increased with increasing levels of maternal smoking. Smoking by the father and other household members increased the risk (odds ratio [OR] = 2.41, 95% CI = 1.92, 3.02 and OR = 1.54, 95% CI = 1.20, 1.99, respectively). Smoking by the father increased the risk of SIDS if the mother smoked, but had no effect if she did not smoke. In analyses controlled for a wide range of potential confounders, smoking by the mother and father was still significantly associated with an increased risk of SIDS. Conclusion. Passive tobacco smoking is causally related to SIDS.

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