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 7,134 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Since 1985, in order to understand variations and factors related to the SIDS compared with the other causes of postneonatal deaths, several epidemiological studies have been carried out in France. The main results obtained so far are presented in this paper. The national rate of SIDS in France is estimated at 1.2 per 1,000 live births. The only specific risk factor for SIDS is age (2-4 months), though birthweight, prematurity and the younger age of the mother increase the probability of dying in the same manner as for accidental causes and all other postneonatal deaths. In addition we found discrepancies in the SIDS rates of babies according to the month of birth. The total probability of dying during the postneonatal period is lower in babies born during spring than in babies born during late summer or autumn. No significant differences were found in the DTP IPV immunization rates between SIDS and other causes of death or between SIDS and living controls.
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PMID:[Sudden infant death: epidemiology]. 148 Sep 28

Disseminated intravascular coagulation (DIC) and other clotting abnormalities are common in sick newborn infants who have a variety of conditions. To document evidence of DIC at autopsy, immunoperoxidase staining of fibrin-related antigens (FRA) was used to detect intravascular microthrombi in liver, kidney, and lung from 127 newborns. Patients were selected from seven major disease groups: hyaline membrane disease/bronchopulmonary dysplasia, infection, meconium aspiration, necrotizing enterocolitis, congenital heart disease, other congenital anomalies, and extreme prematurity. Staining for FRA in intravascular microthrombi was seen in 40% of cases studied. The liver showed the highest frequency of intravascular microthrombi, located predominantly in the sinusoids. Unlike the adult kidney, the newborn kidney seldom had evidence of intravascular coagulation. Extravascular staining of FRA was observed in the renal distal tubular epithelium in 48 cases, many of which also had evidence of intravascular FRA staining. No significant differences in FRA staining patterns were seen among the disease groups except for cases of extreme prematurity in which all tissues showed minimal staining. Control tissues from SIDS patients also showed minimal FRA staining. Hepatic sinusoidal staining was the only tissue finding that correlated with thrombocytopenia, a clinical indicator of DIC. Despite the use of this immunohistochemical staining method, discrepancies between the clinical and autopsy diagnosis of DIC remain.
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PMID:Immunohistochemical diagnosis of disseminated intravascular coagulation in newborns. 170 Apr 4

Over the last 20 years, the sudden infant death syndrome has become the leading cause of death in infants aged one month to one year in developed countries. The SIDS Referral Centers set up in France have been assigned the task of performing thorough clinical, metabolic, infectious and histologic studies. This post-mortem evaluation, whose results are difficult to interpret, is undertaken in an attempt to discriminate between the multiple causes of conditions present at the time of death. This classification task will improve the definition of a number of risk factors. Among these factors, prematurity, perinatal distress requiring resuscitation, and an unfavorable sociocultural environment are often mentioned. Other factors, including intrauterine growth retardation, dysmorphic disorders, impaired regulation of ventilation, heart rhythm anomalies, and inherited defects in fatty acid metabolism are still under study since they are all infrequent. Various combinations of these factors may result in increased vulnerability to stress during the first months of life, the period when SIDS is most common. This ongoing research is indispensable for providing advice and support of the family and developing appropriate individual preventive measures for newborn SIDS siblings.
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PMID:[Sudden infant death syndrome]. 231 67

The purpose of the study was to compare perinatal and infant outcomes of 69 cocaine abusers enrolled in a comprehensive antepartum program (High-Risk Perinatal Project: HRPP) with that of 66 cocaine abusers who did not receive prenatal care (walk-ins) all of whom delivered at the same hospital. The average patient was 26 years of age, gravida 4, para 2, abortion 1. Fifty-seven percent were blacks, 42% Caucasian, and all were on public assistance. No demographic differences were noted between HRPP and walk-in groups. Prematurity rate was 31% for HRPP and 42% for walk-ins. Hospital records, and telephone and mail contact with families were the main source of follow-up data. Seventy-one of the 134 live-born infants were located after their first birthdate. Of the 71 infants, four had died of SIDS, one had AIDS and eight were developmentally delayed. These problems occurred with similar frequency in the HRPP and walk-in groups. The remaining 63 infants were doing well. Right to patient confidentiality prevented agencies (WIC, Dept. Human Resources, Public Health Nurses, Children's Services, etc.) from providing necessary follow-up information. Walk-in patients offer only a limited opportunity for medical and social intervention.
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PMID:Effects of maternal cocaine abuse on perinatal and infant outcome. 233 84

Studies carried out in 1978 and 1981 found postneonatal mortality to be associated with poor environmental conditions. Since then, many changes have occurred to the environment. This study was designed to discover which factors are now associated with a higher risk of postneonatal death. A retrospective case-control study was carried out using 107 cases and 422 controls matched only for date of birth, to look at the effect of area of residence, social class, mother's age, and sex, birthweight, legitimacy and number of siblings. Fifty-eight per cent of the deaths were due to the sudden infant death syndrome, making this the leading cause of death. Causes previously absent from the death certificates are now appearing, particularly prematurity related deaths which now account for almost 6 per cent. The deaths were found to occur more frequently at home, in the winter, and at a peak age of 2 to 4 months. As shown previously in Nottingham, the deaths were more likely to have been male (relative risk 2.03), illegitimate (2.91), and of low birthweight (28.8). Total mortality was significantly higher in babies of mothers aged 19 or less and in babies of manual workers. Surprisingly, babies born to unemployed parents were found to have a very low relative risk of death (0.26). Mortality is still higher in the city than the suburbs and in areas of deprivation. Although still a risk factor for SIDS, high parity of the mother was found to be non-significant for postneonatal mortality in total.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Postneonatal mortality in the Nottingham Health District 1985-1988. 263 15

Sleep apnea and periodic breathing in infants are the result of a mild hypoxia and they are the requirement for SIDS. As a results of the modern medicine each 4.-5. death is the cause of SIDS during the first year of life. The positive effect of theophylline on apnea of prematurity is known since 1973. We have given theophylline (Euphyllin) from 1979 till 1986 to 198 premature infants with a birth weight below 2000 g for apnea prophylaxis orally in a doses of 9 mg/kg body weight per day distributed in 3 to 4 doses for a period of 1 to 4 months. Since then primary apnea in premature infants haven't any importance. Beside the home-monitoring we give theophylline for SIDS. In 1986 and 1987 1041 healthy term newborn infants received theophylline over a period of 6-8 weeks and more then 300 newborns until 6 months and more. There were no deaths from these infants form the cause of SIDS. Since 1987 all newborn infants with a pathological hypoxia-test as a screening test for the risk of SIDS received Euphyllin until normalization. With this method we have reduced evidently the death rate of SIDS in our district.
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PMID:[Experiences with the preventive use of aminophylline (Euphylline) in apnea and periodic respiration in infants]. 304 16

Sudden infant death syndrome is the most common cause of infant death between the ages of 1 week and 1 year of age and accounts for approximately 50 percent of the deaths of infants between the ages of 2 and 4 months. The unique age distribution and its relationship to sleep particularly characterize SIDS; however, there are other factors, such as maternal smoking, male sex, prematurity or low birth weight, which place an infant at higher risk of SIDS. Intrathoracic petechiae with characteristic microscopic topography are the most frequent pathologic finding. However, pulmonary congestive edema and minor microscopic inflammatory infiltrates are often seen. Stenotic lesions within the coronary arteries supplying the conduction system have been identified in a few SIDS victims; however, current evidence favors respiratory dysfunction as the primary mechanism of death in most SIDS babies. Based upon pathologic, experimental, and clinical observations, an argument can be made that upper airway obstruction, e.g., secondary to obstructive sleep apnea, is one, if not a common, cause of death in SIDS. There are cases in which subtle morphologic evidence suggests SIDS represents the termination of a chronic hypoxic/hypoxemic disorder such as recurrent apnea.
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PMID:Sudden infant death syndrome: pathology and pathophysiology. 637 78

In an attempt to identify those infants with resolving chronic lung disease of prematurity (CLD) at greatest risk of sudden infant death syndrome or acute life threatening event (SIDS/ALTE), or readmission to hospital following discharge, recordings of arterial oxygen saturation were made on 35 infants. Recordings were collected while the infants were breathing room air. Movement artefact was excluded and the data analysed to provide the mean individual arterial oxygen saturation (MSaO2), and the variability of the mean individual oxygen saturation (delta MSaO2). These data were related to clinical outcome recorded over the three months following investigation. A MSaO2 less than 90% on discharge predicted hospital admission within three months with a sensitivity of 1 and a specificity of 0.76, and SIDS/ALTE with a sensitivity of 1 and a specificity of 0.75. A delta MSaO2 greater than 6% predicted SIDS/ALTE with a sensitivity 0.88 and specificity of 1. Infants with resolving chronic lung disease of prematurity who are at risk of increased morbidity and mortality can be assessed by accurate measurement of mean arterial saturation.
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PMID:Prediction of early outcome in resolving chronic lung disease of prematurity after discharge from hospital. 866 29

This study presents the findings of 54 infants sent home on event recording apnea/heart rate monitors over a seven month period. The average gestational age was 35 weeks. The number of referring facilities was 13 hospitals and the number of referring physicians was 41. We separated the admitting diagnostic groups into the following categories: Apnea of prematurity, apnea of infancy, apparent life threatening event, subsequent SIDS sibling, gastroesophogeal reflux, maternal substance abuse, seizure disorders, respiratory distress syndrome, bradycardia of unknown origin, bronchopulmonary dysplasia, and Pierre Robin syndrome. From March 1990 to October 1990, a period of seven months, these children were placed in our services on event recording home apnea/heart rate monitors. The average time on service for these patients was 2.90 months, (p less than .07). This data indicates that event recording home apnea/heart rate monitoring greatly decreases the length of home monitoring.
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PMID:The effect of event recording home infant apnea/heart rate monitoring in the greater Los Angeles area. 1014 2

Gastro-oesophageal reflux (GOR) has been identified as a possible cause of SIDS. Several features of GOR unique to infants presenting with apparent life-threatening events (ALTEs) have led to its 'pathogenic' definition. One is that the life-threatening apnoea itself is initiated by GOR, another is that the ALTE relates to prolonged reflux during sleep, in a vulnerable sleep-state, and finally that the ALTE relates to excessive quantities of GOR. The presumption of GOR 'pathology' as a cause of SIDS however, is questionable in these susceptible infants for three reasons: firstly, GOR is physiological and occurs in most infants; secondly, there is no general consensus on what constitutes normal physiological reflux, and thirdly, variation in the recording technique and methods of data analysis and interpretation may account for the differences between study groups. It seems likely therefore if GOR is implicated in SIDS, additional factors are involved. Under certain circumstances, physiological GOR may trigger life-threatening apnoea in apparently healthy infants, that leads to SIDS. One mechanism that could explain such a death is reflex apnoea by stimulation of laryngeal chemoreceptors (LCR) during sleep. The conditions under which this could be fatal are the occurrence of gastric contents refluxed to the level of the pharynx during sleep, in the young infant who has depressed swallowing and arousal. That is, the occurrence of GOR to the level of the pharynx during sleep, an infrequent event that is usually innocuous, could be converted to a fatal event if swallowing is impaired and arousal depressed, by a variety of mediating factors such as prone sleeping, prematurity, sedatives, seizures or upper respiratory tract infections. The identification of LCR responses, particularly in prone sleeping and premature infants provide further evidence that this mechanism may be implicated in the aetiology of SIDS in apparently healthy infants.
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PMID:The role of gastro-oesophageal reflux in the aetiology of SIDS. 1099 49


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