Association Of Sudden Infant Death Syndrome Research Articles

Genetic Association Study of Acetylcholinesterase (ACHE) and Butyrylcholinesterase (BCHE) Variants in Sudden Infant Death Syndrome (SIDS)

Background: Sudden infant death syndrome (SIDS) is the leading cause of death among infants aged between one month and one year. Altered enzyme activities or expression of acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) have been observed in SIDS patients that might lead to disturbed autonomic function and, together with other risk factors, might trigger SIDS. To explore the contribution of AChE and BChE from a genomic viewpoint, we sought to investigate the association between SIDS and selected single nucleotide polymorphisms (SNPs) in the ACHE and BCHE genes. Methods: In this case-control study, 13 potentially regulatory SNPs were selected from ACHE and BCHE and were genotyped in 201 SIDS cases and 338 controls. The association of SIDS with the 11 successfully genotyped candidate variants was examined using statistical analyses of overall or stratified cases and haplotype analyses. Results: No significant overall associations were observed between SIDS and ACHE and BCHE variants in allele, genotype, and haplotype analyses. In subgroup analyses, eight variants were found to be nominally associated with SIDS, though these associations did not remain statistically significant after correction for multiple comparisons. One haplotype (T-C-G-C-C in rs3495-rs1803274-rs1355538-rs2048493-rs1126680) of BCHE was associated with the female SIDS subgroup (57.3% in controls vs. 46.3% in female SIDS cases, p = 0.010). Conclusions: The selected variants in ACHE and BCHE were not overall associated with SIDS in this study, and thus cannot generally explain the previously reported dysregulation of enzyme activities in SIDS. However, some evidence of association in subgroups and a possible contribution of variants other than those tested here would need to be explored in larger studies.

Positioning for acute respiratory distress in hospitalised infants and children

Because of the association of prone positioning with sudden infant death syndrome (SIDS) it is recommended that young infants be placed on their backs (supine). However, the prone position may be a non-invasive way of increasing oxygenation in participants with acute respiratory distress. Because of substantial differences in respiratory mechanics between adults and children and the risk of SIDS in young infants, a specific review of positioning for infants and young children with acute respiratory distress is warranted. To compare the effects of different body positions in hospitalised infants and children with acute respiratory distress. We searched Cochrane Central Register of Controlled Trials (CENTRAL 2012, Issue 3), which contains the Acute Respiratory Infections Group's Specialised Register, MEDLINE (1966 to April week 1, 2012), EMBASE (2004 to April 2012) and CINAHL (2004 to April 2012). Randomised controlled trials (RCTs) or pseudo-RCTs comparing two or more positions in the management of infants and children hospitalised with acute respiratory distress. Two review authors independently extracted data from each study. We resolved differences by consensus or referral to a third review author. We analysed bivariate outcomes using an odds ratio and 95% confidence interval (CI). We analysed continuous outcomes using a mean difference and 95% CI. We used a fixed-effect model unless heterogeneity was significant, in which case we used a random-effects model. We extracted data from 53 studies. We included 24 studies with a total of 581 participants. Three studies used a parallel-group, randomised design which compared prone and supine positions only. The remaining 21 studies used a randomised cross-over design. These studies compared prone, supine, lateral, elevated and flat positions.Prone positioning was significantly more beneficial than supine positioning in terms of oxygen saturation (mean difference (MD) 1.97%, 95% CI 1.18 to 2.77), arterial oxygen (MD 6.24 mm Hg, 95% confidence interval (CI) 2.20 to 10.28), episodes of hypoxaemia (MD -3.46, 95% CI -4.60 to -2.33) and thoracoabdominal synchrony (MD -30.76, 95% CI -41.39 to -20.14). No adverse effects were identified. There were no statistically significant differences between any other positions.As the majority of studies did not describe how possible biases were addressed, the potential for bias in these findings is unclear. The prone position was significantly superior to the supine position in terms of oxygenation. However, as most participants were ventilated preterm infants, the benefits of prone positioning may be most relevant to these infants. In addition, although placing infants and children in the prone position may improve respiratory function, the association of SIDS with prone positioning means that infants should only be placed in this position while under continuous cardiorespiratory monitoring.

Cribs for Kids: Risk and Reduction of Sudden Infant Death Syndrome and Accidental Suffocation

The Cribs for Kids campaign, created in 1998 by a nonprofit voluntary health organization, S. I.D.S. of Pennsylvania, is an innovative program whose aim is to combat infant mortality resulting from sudden infant death syndrome (SIDS) and accidental suffocation in Allegheny County, Pennsylvania. This program was first of its kind in country to include an evaluation component and is germane to social work practice with maternal child health and mental health professionals. This article delineates application of a low-cost but ultimately beneficial intervention to lower risk of SIDS or accidental suffocation by providing education and a safe sleeping environment for infants. SIDS IN THE UNITED STATES SIDS is a frightening phenomenon that has plagued parents for thousands of years. The definition of SIDS is the sudden death of an infant under one year of age, which remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of death scene, and review of clinical history (Willinger, James, & Catz, 1991, pp. 677-678). SIDS strikes an infant during sleep without warning and remains leading cause of postneonatal infant mortality for infants ages one month to one year in Western countries. Neither parents nor physicians can accurately predict which infants will succumb to SIDS, and in United States nearly 3,000 infants die from SIDS each year (National SIDS/Infant Death Resource Center [NSIDRC], 2004b). Despite widespread risk reduction education from Back to Sleep campaign, initiated in 1994 by a coalition of National Institute of Child Health and Human Development (NICHD), Maternal and Child Health Bureau, American Academy of Pediatrics (AAP), SIDS Alliance, and Association of SIDS and Infant Mortality Programs, it remains an alarming social work and public health dilemma that crosses all ethnic, race, and socioeconomic populations (NSIDRC, 2004a). A SIDS diagnosis is made after death, only after all other possible causes have been eliminated. In fact, researchers and medical practitioners are not certain what causes SIDS, although they believe it to involve a dynamic interaction of several factors (NICHD, 2000b). An infant is at increased risk of SIDS if he or she experiences an unstable period of homeostatic control (that is, an inability of infant's body to maintain equilibrium in physiological systems) during sleep combined with triggering factors such as prone sleep position, bed sharing, soft bedding, maternal smoking, viral infections, and premature birth (Filiano & Kinney, 1994). An infant may be born with an underlying vulnerability that increases risk of SIDS (Panigraphy et al., 2000). After American Academy of Pediatrics changed its recommendation of infant sleep position in 1992 (AAP, 1992) there was a 53 percent decrease in number of SIDS deaths in United States by 2001 (Matthews, Menacker, & MacDorman, 2003) .This suggests that prone sleep position for infants as a risk factor for SIDS can be reduced by using a firm, flat mattress; eliminating fluffy bedding from infant's sleep environment; maintaining a smoke-free environment for infant; and avoiding overheating (NICHD, 2001). The Consumer Product Safety Commission (CPSC), AAP, and NICHD responded to these statistics by recommending that all infants younger than 12 months be put to sleep in a crib with no soft bedding on top of or under baby (CPSC, 1999). On October 10, 2005, AAP Task Force on Sudden Infant Death Syndrome issued a revised policy statement on SIDS and reiterated their policy recommendation of back sleep position on a firm mattress with no soft bedding in crib. The task force further recommended that infant sleep in same room as mother to facilitate breastfeeding, but on a separate sleep surface, such as a crib, bassinet, or cradle that meets CPSC standards for safety. …

Is SIDS associated with sleep? : A report of six cases demonstrating difficulty in this determination.

Epidemiological studies suggest an important association of sudden infant death syndrome (SIDS) with sleep. Because these deaths are very rarely observed, this association is difficult to confirm. When nearby caretakers hear noises suggesting that some infants are awake before their deaths from SIDS, this determination may be even more difficult. We report six cases illustrating the difficulty in determining the sleep status of SIDS infants immediately prior to their deaths. A retrospective analysis was undertaken of the San Diego SIDS/SUDC Research Project database and the new SIDS definition proposed at the January 2004 conference in San Diego, California was applied. The circumstances surrounding the deaths of six infants led nearby caretakers to speculate that all were awake before dying. However, careful analyses suggest that all but one infant were actually sleeping before their deaths. This study strengthens the association of SIDS with sleep and emphasizes the importance of very detailed evaluation of the circumstances of death in all cases of sudden infant death. The use of the recently stratified definition for SIDS as well as the new category of unclassified sudden infant death (USID) is recommended.