Original articleSudden infant death syndrome: Risk factors for infants found face down differ from other SIDS cases
Section snippets
Methods
The New Zealand Cot Death Study has been described previously.6, 7 This was a large, multicenter, case-control study of infants who died of SIDS between 28 days of age and completion of their first year of life (postneonatal deaths) in the period November 1, 1998, to October 31, 1990. A standard definition for SIDS was used.8 Most of the data collected preceded the SIDS prevention campaign. There were 716 postneonatal deaths, of which 485 were classified as SIDS. Obstetric records were examined
Results
Risk factors that showed an interaction between FD and NFD SIDS at the univariate level are shown in the Table (available at www.jpeds.com). An interaction means that there was a statistically significant difference in the magnitude of the odds ratios between the FD and NFD groups. After adjustment for potential confounders in the model, all but age of the mother at pregnancy remained significantly different between the FD and NFD groups. Younger infant age, Maori ethnicity, low birth weight,
Discussion
In this study, risk factors for SIDS differ markedly between infants found dead FD and those found dead in other positions. The findings provide new insights into the pathophysiology of SIDS. The group of infants found FD are uniquely associated with risk factors closely linked to causal theories derived from physiological data. The increased risk of SIDS with the use of pillows and sheepskins are only seen with FD SIDS. These are items of bedding likely to be placed beneath an infant’s head
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Cited by (22)
The socio-economic status of families experiencing the sudden unexpected death of an infant – Is it possibly related to a higher rate of non-natural deaths among them
2021, Journal of Forensic and Legal MedicineCitation Excerpt :One of the first was by Maria Valdés-Dapena in the 1960s17 who found that the majority of SIDS cases occurred: in the low and middle socio-economic groups in Philadelphia; more frequently among blacks than whites, rating from 5 per 1000 to 1.9 per 1000, respectively, in the lowest socio-economic groups. Thompson et al.18 looked into the socio-demographic background of the mothers’ marital status, age, the age they left school, occupation, ethnicity and pregnancy variables (parity, age of mother at first pregnancy, attendance at antenatal clinics and education classes). in terms of independent variables in a facedown versus non-facedown sleep position of SIDS cases, The study found that families with a low SES and other negative attributes, were often late in taking preventive interventions, that is, in avoiding a prone or side sleeping position.
Parent-child bed-sharing: The good, the bad, and the burden of evidence
2017, Sleep Medicine ReviewsCitation Excerpt :For instance, bed-sharing SIDS cases exhibit a smaller male to female ratio (2:1 for solitary sleeping and 0.8:1 for bed-sharing) [337], greater hypoxia exposure [338], and lower levels of beta-amyloid precursor protein (a biomarker of traumatic axonal injury) [339] compared with solitary sleeping SIDS cases. Furthermore, bed-sharing is associated with a greater risk of SIDS in the non face-down group of children, but not in the face-down group of children [340]. Yet another theory suggests infants dying of SIDS have a dietary insufficiency in selenium and iodine, which can compromise nighttime thermoregulation and elevate SIDS risks in bed-sharers [341].
Cumulative effects of repetitive intermittent hypercapnic hypoxia on orexin in the developing piglet hypothalamus
2016, International Journal of Developmental NeuroscienceCitation Excerpt :SIDS is the sudden unexpected death of a seemingly healthy infant under one year of age during sleep (Krous et al., 2004). Both OSA and two prominent risk factors of SIDS, prone sleeping and bed sharing, reproduce the re-breathing of expired air, thereby exposing the infants to repeated episodes of IHH (Thompson et al., 2006; Dwyer and Ponsonby, 2009; Harper and Kinney, 2010; Baddock et al., 2012). Piglet models of IHH were developed in our laboratory in the 1990s, in order to determine the pathophysiology of IHH in pediatric OSA, and as a model of prone sleeping and bed sharing during infancy (Waters and Tinworth, 2001; Waters and Gozal, 2003).
Orexin receptors in the developing piglet hypothalamus, and effects of nicotine and intermittent hypercapnic hypoxia exposures
2013, Brain ResearchCitation Excerpt :As such the prevention of risk factors such as the prone sleeping position and cigarette smoke exposure are important (Dwyer et al., 2009; Dwyer and Ponsonby, 2009). Prone sleeping promotes the rebreathing of expired air and as such the infant is exposed to HH (Thompson et al., 2006). It is proposed that a defect in arousal occurs in SIDS infants (Kato et al., 2003) and that exposure to HH may promote this defect (Sawaguchi et al., 2002).
Apnea of Prematurity, Sudden Infant Death Syndrome, and Apparent Life-Threatening Events
2008, Pediatric Respiratory MedicineCurrent concepts on risk and protective factors for sudden infant death syndrome
2007, Archives de Pediatrie
The New Zealand Cot Death Study was supported by the Medical Research Council of New Zealand and Hawkes Bay Medical Research foundation. Professor Ed Mitchell and Dr John Thompson are supported in part by the Child Health Research Foundation. This research is supported by Grant HD 10993.