Defining Sudden Infant Death and Sudden Intrauterine Unexpected Death Syndromes with Regard to Anatomo-Pathological Examination

Ottaviani, Giulia

doi:10.3389/fped.2016.00103

Cited by 24 publications

(30 citation statements)

References 26 publications

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“…In the global dataset the two phenotypes predict SIDS better than each phenotype separately, whereas in the US MNC and prematurity predict unexplained mortality only better than MNC. Much of the difficulties in studying SIDS pertains to terminological [77] and methodological problems [78]. SIDS is a diagnosis of exclusion given when the cause of death cannot be determined.…”

Section: Discussionmentioning

confidence: 99%

Neonatal circumcision and prematurity are associated with sudden infant death syndrome (SIDS)

Elhaik

2018

J Clin Transl Res

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Background: Sudden infant death syndrome (SIDS) is the most common cause of postneonatal unexplained infant death. The allostatic load hypothesis posits that SIDS is the result of cumulative perinatal painful, stressful, or traumatic exposures that tax neonatal regulatory systems. Aims: To test the predictions of the allostatic load hypothesis we explored the relationships between SIDS and two common phenotypes, male neonatal circumcision (MNC) and prematurity. Methods: We collated latitudinal data from 15 countries and 40 US states sampled during 2009 and 2013. We used linear regression analyses and likelihood ratio tests to calculate the association between SIDS and the phenotypes. Results: SIDS mortality rate was significantly and positively correlated with MNC. Globally (weighted): Increase of 0.06 (95% CI: 0.01-0.1, t = 2.86, p = 0.01) per 1000 SIDS mortality per 10% increase in circumcision rate. US (weighted): Increase of 0.1 (95% CI: 0.03-0.16, t = 2.81, p = 0.01) per 1000 unexplained mortality per 10% increase in circumcision rate. US states in which Medicaid covers MNC had significantly higher MNC rates (χ = 0.72 vs 0.49, p = 0.007) and male/female ratio of SIDS deaths (χ = 1.48 vs 1.125, p = 0.015) than other US states. Prematurity was also significantly and positively correlated with MNC. Globally: Increase of 0.5 (weighted: 95% CI: 0.02-0.086, t = 3.37, p = 0.004) per 1000 SIDS mortality per 10% increase in the prematurity rates. US: Increase of 1.9 (weighted: 95% CI: 0.06-0.32, t = 3.13, p = 0.004) per 1000 unexplained mortalities per 10% increase in the prematurity rates. Combined, the phenotypes increased the likelihood of SIDS. Conclusions: Epidemiological analyses are useful to generate hypotheses but cannot provide strong evidence of causality. Biological plausibility is provided by a growing body of experimental and clinical evidence linking aversive preterm and early-life SIDS events. Together with historical and anthropological evidence, our findings emphasize the necessity of cohort studies that consider these phenotypes with the aim of improving the identification of at-risk infants and reducing infant mortality. Relevance for patients: Preterm birth and neonatal circumcision are associated with a greater risk of SIDS, and efforts should be focused on reducing their rates.

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Section: Discussionmentioning

confidence: 99%

Neonatal circumcision and prematurity are associated with sudden infant death syndrome (SIDS)

Elhaik

2018

J Clin Transl Res

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“…In spite of continuous research and global BTS campaigns, SIDS remains the leading cause of death among infants between birth and 1 year of age [3]. Much of the difficulties in studying SIDS pertain to terminological [43] and methodological issues [44]. SIDS is a diagnosis of exclusion given when the cause of death cannot be determined.…”

Section: Discussionmentioning

confidence: 99%

Adversarial childhood events are associated with Sudden Infant Death Syndrome (SIDS): an ecological study

Elhaik

2018

Preprint

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Sudden Infant Death Syndrome (SIDS) is the most common cause of postneonatal infant death. The allostatic load hypothesis posits that SIDS is the result of perinatal cumulative painful, stressful, or traumatic exposures that tax neonatal regulatory systems. To test it, we explored the relationships between SIDS and two common stressors, male neonatal circumcision (MNC) and prematurity, using latitudinal data from 15 countries and over 40 US states during the years 1999-2016. We used linear regression analyses and likelihood ratio tests to calculate the association between SIDS and the stressors. SIDS prevalence was significantly and positively correlated with MNC and prematurity rates. MNC explained 14.2% of the variability of SIDS's male bias in the US, reminiscent of the Jewish myth of Lilith, the killer of infant males. Combined, the stressors increased the likelihood of SIDS. Ecological analyses are useful to generate hypotheses but cannot provide strong evidence of causality. Biological plausibility is provided by a growing body of experimental and clinical evidence linking adversary preterm and early-life events with SIDS. Together with historical evidence, our findings emphasize the necessity of cohort studies that consider these environmental stressors with the aim of improving the identification of at-risk infants and reducing infant mortality.

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“…Sudden intrauterine unexplained death syndrome (SIUDS) is defined as the "sudden death of a fetus after the twenty-fifth week of gestation and sudden infant death syndrome (SIDS) the sudden death of an infant under the age of 1 year, which is unexplained following thorough examination of the clinical case, history, death scene and autopsy (1). Although the rates of SIDS have decreased during recent years due to successful public health campaigns (2,3), the rates of SIUDS have remained largely unchanged and account for > 50% of stillbirths (1,(4)(5)(6). Despite modern advances, the pathophysiology remains unexplained, but is likely to be multi-factorial (7).…”

Section: Introductionmentioning

confidence: 99%

“…There have been many suggestions for the mechanism resulting in mortality including abnormal cardiorespiratory control, autonomic nervous system abnormalities and failure of arousal from sleep (7,9,10). Unfortunately, much less is understood about the pathogenesis underlying SIUDS, although there is likely to be an overlap (1).…”

Section: Introductionmentioning

confidence: 99%

The Role of Maternal Smoking in Sudden Fetal and Infant Death Pathogenesis

2020

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Maternal smoking is a risk factor for both sudden infant death syndrome (SIDS) and sudden intrauterine unexplained death syndrome (SIUDS). Both SIDS and SIUDS are more frequently observed in infants of smoking mothers. The global prevalence of smoking during pregnancy is 1.7% and up to 8.1% of women in Europe smoke during pregnancy and worldwide 250 million women smoke during pregnancy. Infants born to mothers who smoke have an abnormal response to hypoxia and hypercarbia and they also have reduced arousal responses. The harmful effects of tobacco smoke are mainly mediated by release of carbon monoxide and nicotine. Nicotine can enter the fetal circulation and affect multiple developing organs including the lungs, adrenal glands and the brain. Abnormalities in brainstem nuclei crucial to respiratory control, the cerebral cortex and the autonomic nervous system have been demonstrated. In addition, hypodevelopment of the intermediolateral nucleus in the spinal cord has been reported. It initiates episodic respiratory movements that facilitate lung development. Furthermore, abnormal maturation and transmitter levels in the carotid bodies have been described which would make infants more vulnerable to hypoxic challenges. Unfortunately, smoking cessation programs do not appear to have significantly reduced the number of pregnant women who smoke.

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Defining Sudden Infant Death and Sudden Intrauterine Unexpected Death Syndromes with Regard to Anatomo-Pathological Examination

Cited by 24 publications

References 26 publications

Neonatal circumcision and prematurity are associated with sudden infant death syndrome (SIDS)

Neonatal circumcision and prematurity are associated with sudden infant death syndrome (SIDS)

Adversarial childhood events are associated with Sudden Infant Death Syndrome (SIDS): an ecological study

The Role of Maternal Smoking in Sudden Fetal and Infant Death Pathogenesis

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