Do risk factors differ between explained sudden unexpected death in infancy and sudden infant death syndrome? | Archives of Disease in Childhood

Subscribe
Log In More

Log in via Institution
Log in via OpenAthens
Log in via RCPCH

Log in using your username and password
For personal accounts OR managers of institutional accounts

Username *

Password *

Forgot your log in details?Register a new account?
Forgot your user name or password?
Basket
Search More

Search for this keyword

Advanced search

Responses

Original article

Do risk factors differ between explained sudden unexpected death in infancy and sudden infant death syndrome?

Free

Compose a Response to This Article

Compose Response

Title *

Author Information

Contributors
First Name and Middle Initial * First or given name, e.g. 'Peter'. Last Name * Your last, or family, name, e.g. 'MacMoody'. Email Address * Your email address, e.g. higgs-boson@gmail.com Occupation * Your role and/or occupation, e.g. 'Orthopedic Surgeon'. Affiliation * Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.

Statement of Competing Interests

Competing interests? *

Yes

No

Please describe the competing interests

PLEASE NOTE:

A rapid response is a moderated but not peer reviewed online response to a published article in a BMJ journal; it will not receive a DOI and will not be indexed unless it is also republished as a Letter, Correspondence or as other content. Find out more about rapid responses.
We intend to post all responses which are approved by the Editor, within 14 days (BMJ Journals) or 24 hours (The BMJ), however timeframes cannot be guaranteed. Responses must comply with our requirements and should contribute substantially to the topic, but it is at our absolute discretion whether we publish a response, and we reserve the right to edit or remove responses before and after publication and also republish some or all in other BMJ publications, including third party local editions in other countries and languages
Our requirements are stated in our rapid response terms and conditions and must be read. These include ensuring that: i) you do not include any illustrative content including tables and graphs, ii) you do not include any information that includes specifics about any patients,iii) you do not include any original data, unless it has already been published in a peer reviewed journal and you have included a reference, iv) your response is lawful, not defamatory, original and accurate, v) you declare any competing interests, vi) you understand that your name and other personal details set out in our rapid response terms and conditions will be published with any responses we publish and vii) you understand that once a response is published, we may continue to publish your response and/or edit or remove it in the future.
By submitting this rapid response you are agreeing to our terms and conditions for rapid responses and understand that your personal data will be processed in accordance with those terms and our privacy notice.

I agree to and have read the terms and conditions for rapid responses and BMJ Privacy Notice *

CAPTCHA

This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

Other responses

Jump to comment:

Risk factors for explained vs. unexplained SIDS
Monique P. L'Hoir
Published on: 5 March 2007

Published on: 5 March 2007
Risk factors for explained vs. unexplained SIDS
- Monique P. L'Hoir
- Other Contributors:
  Bregje E. van Sleuwen, Jonne Huber, Adèle C. Engelberts
Dear Editor,
We read the article ”Do risk factors differ between explained sudden unexpected death in infancy and sudden infant death syndrome?” by Vennemann et al (1) with great interest. We were surprised by the statement that this is the first study to examine the sleep environment in explained sudden death in infancy, however. In 1998 we performed a similar, although smaller study, in which one of the papers...
Show More

Dear Editor,
We read the article ”Do risk factors differ between explained sudden unexpected death in infancy and sudden infant death syndrome?” by Vennemann et al (1) with great interest. We were surprised by the statement that this is the first study to examine the sleep environment in explained sudden death in infancy, however. In 1998 we performed a similar, although smaller study, in which one of the papers authors participated (2) and which was commented upon by another (3).
Our study was part of the ECAS study, the European Concerted Action on SIDS. All deaths were independently analyzed by three paediatric pathologists into SIDS, borderline SIDS and non-SIDS. Epidemiological data was collected prior to categorization on basis of autopsy. We compared sleeping environment and known risk factors for SIDS between the three groups, but did not include living controls in this specific analysis, as did the English CESDI and German SIDS studies. There are some interesting similarities and differences between our study and Vennemann et al’s.
All in all we found more indication of socio-economic disadvantage in the SIDS group, although we had hypothesized that this would also carry added risk for explained sudden death. There was more maternal smoking. Except for a soft/intermediate mattress, bedding factors did not differ. In the larger German study there was no difference in socio-economic disadvantage between groups but these findings are always difficult to extrapolate to other countries. Vennemann found no difference between SIDS and explained infant death as to dummy use and bed sharing. Our study also found no difference between the groups as to dummy use and no difference in bed-sharing between the SIDS cases and explained deaths. However, the borderline SIDS cases actually bed-shared significantly less than the SIDS cases, an unexpected finding as we had expected borderline SIDS cases to have more symptoms, be more fussy and therefore have more chance of winding up the parental bed. The number of bed-sharing infants was very small, as this was still very uncommon in the Netherlands at the time, which makes statistical significance difficult to achieve, but 4 of 19 (21%) SIDS cases bed shared compared to none of 30 borderline SIDS cases and 1 of 14 (7%) explained deaths.
As to sleeping position between the groups our findings differ somewhat. There was no difference between SIDS, borderline SIDS and explained death in the number of infants placed prone or turned to prone. This is in contrast to the findings of Vennemann et al. However, the SIDS infants were found prone for the first time significantly more often. It is known that inexperienced prone sleeping (being placed prone or having turned to prone for the first time) is an even larger risk factor for SIDS than prone sleeping per se. We would be interested to know if inexperienced prone sleeping was also unique for the SIDS group in the German study and if prone position was still unique to the SIDS group in those more accustomed to it.
Monique P. L’Hoir, MSc, PhD Wilhelmina Children’s Hospital University Medical Center Utrecht Utrecht, The Netherlands
Bregje E. van Sleuwen, MSc Wilhelmina Children’s Hospital University Medical Center Utrecht Utrecht, The Netherlands
Prof. J. Huber, pathologist Moerkapelle The Netherlands
Adèle C. Engelberts, MD, PhD Department of Pediatrics Maaslandziekenhuis Sittard, The Netherlands
References:
1. Venneman M, Bajanowski T, Buuterfass-Bahloul T, Saureland C, Jorch G, Brinkmann B, Mitchell EA. Do risk factors differ between explained sudden unexpected death in infancy and sudden infant death syndrome? Arch Dis Child 2007;92:133-36.
2. L’Hoir MP, Engelberts AC, Well van G.Th.J., Bajanowski T, Helweg-Larsen K, Westers P. Mellenbergh GJ, Wolters WHG, Huber J. Sudden unexpected death in infancy; epidemiologically determined risk factors related to pathology classification. Acta Paediatrica 1998; 87(12):1279-87.
3. Mitchell EA, Becroft DM. An adequate cause of death? Acta Paediatr 1998; 87 (12):1217-1218.
Show Less

Conflict of Interest:
None declared.
- Back to top