Case control study of thermal environment preceding haemorrhagic shock encephalopathy syndrome
C J Bacona, S A Bellb, J M Gaventac, D C Greenwoodd
a Friarage Hospital,
Northallerton, North Yorkshire DL6 1JG, UK, b Department of Child Health, Royal Victoria
Infirmary, Newcastle upon Tyne NE1 4LP, UK, c Institute of Child Health, London WC1N 1EH, UK, d Medical
Statistics, Nuffield Institute for Health, Leeds LS2 9PL, UK
Correspondence to: Dr Bacon.
Accepted 26 March 1999
The purpose of the study was to investigate whether the thermal
environment in which babies slept before developing haemorrhagic shock
encephalopathy syndrome (HSES) differed from that of other babies. Data
were collected by standardised interview from parents of 31 babies who
had had HSES before the age of 7 months and compared with equivalent
data for 124 control babies, with matching for outside temperature on
the relevant night and for age. Multivariate analysis showed a strong
association between HSES and covering of the baby's head by bedding,
the odds ratio being 30.7 (95% confidence interval, 2.5 to 384). There
were weaker associations with other aspects of the thermal environment.
This suggests a link between HSES and some cases of cot death, supports
the suggestion that HSES may be caused by overheating, and reinforces
advice that babies should be placed to sleep in such a way that they are less likely to become totally covered.
Keywords: haemorrhagic shock encephalopathy syndrome; head covering; sudden infant death syndrome; overheating; hyperthermia
© 1999 by Archives of Disease in Childhood
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