scholarly journals Revisiting the Neuropathology of Sudden Infant Death Syndrome (SIDS)

2020 ◽  
Vol 11 ◽  
Author(s):  
Jessica Blackburn ◽  
Valeria F. Chapur ◽  
Julie A. Stephens ◽  
Jing Zhao ◽  
Anne Shepler ◽  
...  
Keyword(s):  
Machine Learning ◽  
Risk Factors ◽  
Birth Weight ◽  
Infant Mortality ◽  
Sudden Infant Death Syndrome ◽  
Sudden Infant Death ◽  
Sudden Infant ◽  
Normal Birth Weight ◽  
Normal Birth ◽  
Extrinsic Risk

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.

Relationship Between Epidemiologic Risk Factors and Clinicopathologic Findings in the Sudden Infant Death Syndrome

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 ◽  
...  
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Great Majority ◽  
Sudden Infant Death ◽  
Postnatal Growth ◽  
Birth Certificates ◽  
Sudden Infant

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.

scholarly journals An Approach to the Classification of Apparent Asphyxial Infant Deaths

2017 ◽  
Vol 7 (2) ◽  
pp. 200-211 ◽  
Author(s):  
Evan W. Matshes ◽  
Emma O. Lew
Keyword(s):  
Risk Factors ◽  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Sudden Infant Death ◽  
Sudden Infant ◽  
Death Certification ◽  
High Quality ◽  
Infant Deaths ◽  
Unexpected Infant Death

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.

scholarly journals Genomic risk factors in sudden infant death syndrome

10.1186/gm207 ◽  
2010 ◽  
Vol 2 (11) ◽  
pp. 86 ◽  
Author(s):  
David W Van Norstrand ◽  
Michael J Ackerman
Keyword(s):  
Risk Factors ◽  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Sudden Infant Death ◽  
Sudden Infant ◽  
Genomic Risk

Risk Factors for Sudden Infant Death Syndrome Following the Prevention Campaign in New Zealand: A Prospective Study

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 ◽  
...  
Keyword(s):  
Risk Factors ◽  
New Zealand ◽  
Prospective Study ◽  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Sudden Infant Death ◽  
Sudden Infant ◽  
Prevention Campaign ◽  
A Prospective Study

Sudden Infant Death Syndrome in Infants With Bronchopulmonary Dysplasia

PEDIATRICS ◽  
1982 ◽  
Vol 69 (3) ◽  
pp. 301-304 ◽  
Author(s):  
Joseph Werthammer ◽  
Elizabeth R. Brown ◽  
Raymond K. Neff ◽  
H. William Taeusch
Keyword(s):  
Birth Weight ◽  
Bronchopulmonary Dysplasia ◽  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Harvard Medical School ◽  
Sudden Infant Death ◽  
Multiple Birth ◽  
Sudden Infant ◽  
Confounding Factors ◽  
Low Birth Weight Infants

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.

scholarly journals What risk factors for sudden infant death syndrome are preterm and term medically complex infants exposed to at home?

2020 ◽  
Author(s):  
Ian Mitchell ◽  
Daniel Y Wang ◽  
Christine Troskie ◽  
Lisa Loczy ◽  
Abby Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Respiratory Syncytial Virus ◽  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Maternal Smoking ◽  
Sudden Infant Death ◽  
Sudden Infant ◽  
Term Infants ◽  
Medical Complexity ◽  
Syncytial Virus

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.

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