Optimality of the birth population reduces learning and behaviour disorders and sudden infant death after the first month

Abstract

Saugstad LF. Optimality of the birth population reduces learning and behaviour disorders and sudden infant death after the first month. Acta Paediatr 1999; Suppl 429: 9-28. Stockholm. ISSN 0803-5326The weight distribution pattern of all births can be divided into a "skewing to the left" to lower weights and high neonatal mortality, a "skewing to the right" to higher weights (b3500 g) and minimum neonatal and postneonatal mortality, and a "symmetrical distribution" with mortality in between. This study was initiated with the hypothesis that a deficit in newborns of more than 3500 g would adversely affect postneonatal death. Higher and rising postneonatal mortality solely attributable to sudden infant death of unknown cause (sudden infant death syndrome; SIDS) was observed in the Nordic countries with a lower proportion of heavy newborns. Minor environmental intervention almost eliminated excess mortality from this cause, supporting raised susceptibility with a depressed birthweight in postneonatal SIDS. This contrasts with classical neonatal low birthweight SIDS, which is stable despite numerous attempts at reduction, supporting a multifactorial aetiology: low maternal age, low education, low socioeconomic status, maternal smoking, infection, etc. The postneonatal SIDS epidemic associated with a deficit in heavy newborns is thought to be a result of changing behaviour in pregnancy: moderate iatrogenic dietary restriction and young women favouring a low-calorie, low-fat diet, especially in the third trimester when the foetus is most vulnerable, which delays myelination and somatic growth and renders the infant susceptible to minor morbidity and irregularity. The timing of death and neuropathological findings suggestive of repeated hypoxic episodes in more than 80% of cases of SIDS prior to death support this theory. The similar weight distribution patterns in SIDS and all births in Denmark, the UK and the USA suggest a substantial proportion of the neonates in these countries could be growthretarded and at risk of hypoxic episodes in infancy. A few cases, particularly males (sexratio = 1.7), suffer SIDS, the majority survive. Many, mostly males, present minor CNS signs and learning and behaviour problems. The male predominance accords with males more than 500 g higher optimal birthweight than females and susceptibility to a depressed weight at birth. In order to prevent postneonatal dying, SIDS and reduce learning/behaviour disorders it is necessary to raise the proportion of heavy newborns by promoting foetal growth rate equal to the maternal intrinsic rate by eating to one's appetite a balanced diet, favouring a diet high in marine fat, especially in third trimester, in order to ensure maturation of the CNS and prolong gestation, thereby increasing birthweight. Although the increased survival of some very low birthweight neonates confounds the issue, a division between SIDS in neonatal and postneonatal death is recommended in order to assess the proportion of "avoidable infant death" as opposed to persistent clas...

Effective societal knowledge management

“…B State-of-the-art government and industrial programs for basic and applied R&D. educational achievements through school and college (Coffey and McCain, 2002;Saugstad, 1999).…”

Prenatal and perinatal risk factors for autism

“…Environmental risk factors occurring during the prenatal and perinatal periods of development have been found to be etiologically important de-Brought to you by | Universität Osnabrück Authenticated Download Date | 5/27/15 5:42 AM terminants of developmental disorders [33]. The roles of prenatal exposure to maternal smoking in attention deficit hyperactivity disorder [27] or conduct disorder [39] and prenatal alcohol exposure and the resulting fetal alcohol syndrome [11,4] are examples.…”

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“…SIDS birthweight averaged 200-300g lower than the surviving siblings. Omega-3 levels in SIDS brainstems were lower than controls as it had been insufficiently provided in 3rd trimester (Saugstad, 1997b(Saugstad, , 1999b. Our modem diet is increasingly deficient in LCPUFA to such a degree that a deficit in Olfaction is common (Hichami et al, 2007).…”