Sudden infant death syndrome: current perspectives

Abstract

Despite significant reductions in incidence since the introduction of safe infant sleeping recommendations, sudden infant death syndrome is still the major cause of neonatal death in western countries. In the United States, over 2500 infants die suddenly and unexpectedly each year with nearly 100 deaths annually in Australia. Health professionals play a critical role in advising parents how to sleep their infants safely to minimise the risk of sudden infant death syndrome and sleeping accidents. Infants should be placed supine to sleep in a cot with a firm well‐fitting mattress in the parental bedroom with no soft or loose bedding which could obstruct the airway. Exposure to smoking both before and after birth should be minimised. Breastfeeding should be encouraged, as should immunisation. Dummies can be recommended after breastfeeding has been established. This review outlines the evidence behind these recommendations.

Gene variants associated with obstructive sleep apnea (OSA) in relation to sudden infant death syndrome (SIDS)

“…Maternal risk factors such as smoking (prenatal and postnatal) [7], and environmental factors-for example, thermal stress (warmth) and soft bedding have also been identified to increase the risk for SIDS. These risk factors have been studied and confirmed in recent studies [8][9][10].…”

Maternal intentions towards infant sleeping practices in Ireland

“…[2][3][4][5][6][7] This is mostly due to the 'Back to Sleep' campaign, which has been credited as one of the great achievements of paediatric research in the past 40 years. 8 Currently, SIDS accounts for up to 50% of post-neonatal infant mortality in the developed world, 4,7,9 causing 41.7% of Irish post-neonatal infant deaths in 2017. 10 In Ireland, SIDS has fallen by 85% since 1990, from 2.2 to 0.33/1000 live births (Figure 1).…”

“…The National Institute for Health and Care Excellence states there is insufficient evidence to suggest co‐sleeping causes SIDS, although a statistical relationship does exist between them 16 . However, other studies suggest that bedsharing increases SIDS, in the absence of any other factors, for the first 20 weeks of life [AOR: 2.7‐23] 3,7,9,14,19 . Case‐control studies estimate that 37% of SIDS deaths are due to bedsharing, 15 with 90% of bedsharing deaths directly attributable to bedsharing 7 .…”

The battle with uneven opponent – Sudden Infant Death Syndrome

“…SIDS diagnozuje się przez wykluczenie -jeżeli w badaniu i wywiadzie lekarskim nie stwierdza się żadnych czynników, które mogłyby być bezpośrednią przyczyną śmierci, uznaje się to za SIDS. Najwięcej tego typu zdarzeń ma miejsce między 2. a 6. miesiącem życia, sugeruje to, że przyczyną mogą wynikać z nieprawidłowości rozwojowych oraz upośledzenia ośrodków kontrolujących sen i czuwanie [4]. Hipotezy mające na celu wyjaśnienie etiopatologii śmierci łóżeczkowej weryfikowane są na drodze neuropatologicznych badań pośmiertnych, również na poziomie molekularnym oraz za pomocą licznych badań eksperymentalnych mających na celu poznanie mechanizmu prowadzącego do zatrzymania funkcji układów niezbędnych do życia [5].…”