Please find below a reference list of recently published, peer-reviewed papers relating to SIDS or SUDI. The references have kindly been supplied by members of ISPID and may include papers in press. Any publication will be listed here for no longer than 2 years.
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Quality of investigations into unexpected deaths of infants and young children in England after implementation of national child death review procedures in 2008: a retrospective assessment. Fleming P, Pease A, Ingram J, Sidebotham P, Cohen MC, Coombs RC, Ewer AK, Ward Platt M, Fox J, Marshall D, Lewis A, Evason-Coombe C, Blair P. Arch Dis Child 2019; pii: archdischild-2019-317420. doi:10.1136/archdischild-2019-317420
"In 2008, new statutory national procedures for responding to unexpected child deaths were introduced throughout England. There has, to date, been no national audit of these procedures. Data were obtained from 91 bereaved families. Documentation of multiagency assessments was poorly recorded. Most (88%) families received a home visit from the police, but few (37%) received joint visits by police and healthcare professionals. Postmortem examinations closely followed national guidance; 94% involved paediatric pathologists; 61% of families had a final meeting with a paediatrician to explain the investigation outcome. There was no improvement in frequency of home visits by health professionals or final meetings with paediatricians between 2008-2013 and 2014-2017 and no improvement in parental satisfaction with the process. Statutory procedures need to be followed more closely. The implementation of a national child mortality database from 2019 will allow continuing audit of the quality of investigations after unexpected child deaths. An important area amenable to improvement is increased involvement by paediatricians."
Innovation to prevent sudden infant death: the wahakura as an Indigenous vision for a safe sleep environment. Tipene-Leach D, Abel S. Aust J Prim Health 2019. doi:10.1071/PY19033
"The bassinet-like wahakura is an Indigenous initiative for the prevention of Sudden Unexpected Death in Infancy (SUDI). It was developed by New Zealand Māori in 2005 when Māori were rejecting the 'stop bedsharing' SUDI prevention message and the SUDI disparity between Māori and non-Māori had become entrenched. Made of native flax, the wahakura was promoted as a culturally resonant, in-bed safe sleep device that would disrupt the SUDI risk associated with 'bedsharing where there was smoking in pregnancy' without relying on smoking cessation. A significant movement of weavers and health professionals grew around the wahakura program. A body of research, including infant care surveys, retrospective case review, qualitative enquiry and a randomised controlled trial comparing wahakura and bassinet safety demonstrated the device's public health plausibility, acceptability to Māori women and its essential safety. This facilitated the distribution, by District Health Boards, of safe sleep devices, including a related device called the Pēpi-Pod, and safe sleep education to high-risk, mainly Māori, mothers. Infant mortality in New Zealand fell by 29%, primarily among Māori infants, over the period 2009-15, suggesting that Māori cultural concepts, traditional activities and community engagement can have a significant effect on ethnic inequities in infant mortality."
Pre-loss personal factors and prolonged grief disorder in bereaved mothers. Goldstein RD, Petty CR, Morris SE, Human M, Odendaal H, Elliott A, Tobacco D, Angal J, Brink L, Kinney HC, Prigerson HG; PASS Network. Psychol Med 2019; 49 (14): 2370-2378. doi:10.1017/S0033291718003264
"Identifying characteristics of individuals at greatest risk for prolonged grief disorder (PGD) can improve its detection and elucidate the etiology of the disorder. The Safe Passage Study, a study of women at high risk for sudden infant death syndrome (SIDS), prospectively examined the psychosocial functioning of women while monitoring their healthy pregnancies. Mothers whose infants died of SIDS were followed in bereavement. Six personal factors (anxiety, depression, alcohol use, previous loss, living child in the home, and maternal age) predicted PGD in 2 years of bereavement. There is a convergence of risk groups to high rates at 2–3 years, marked by increased PGD rates in mothers at low risk. The risk factors showed different effects on PGD."
Prolongation of bronchopulmonary C-fiber-mediated apnea by prenatal nicotinic exposure in rat pups: role of 5-HT3 receptors. Zhao L, Gao X, Zhuang J, Wallen M, Leng S, Xu F. FASEB J 2019; 33 (10): 10731-10741. doi:10.1096/fj.201900279RR
"Prenatal nicotinic exposure (PNE) reportedly sensitizes bronchopulmonary C-fibers (PCFs) and prolongs PCF-mediated apnea in rat pups, contributing to the pathogenesis of sudden infant death syndrome. Our results showed that PNE up-regulated the pulmonary 5-HT concentration and strengthened the PCF 5-HT3R-mediated apnea. PNE significantly facilitated neural excitability by shortening the decay time of 5-HT3R currents, lowering the stimulus threshold, and increasing 5-HT3B IR. In summary, PNE prolongs the apnea mediated by 5-HT3Rs in PCFs, likely by increasing 5-HT3B subunits to enhance the excitability of 5-HT3 channels."
Promoting smoke-free homes through biomarker feedback documenting child exposure to tobacco toxins: protocol for a randomized clinical trial. Thomas JL, Schreier M, Luo X, Lowry S, Hennrikus D, An L, Wetter DW, Ahluwalia JS. JMIR Res Protoc 2019; 8 (10): e12654. doi:10.2196/12654
This study aims to test a novel approach to motivate the adoption of home smoking restrictions and to eliminate child SHS exposure by providing parents with objective data documenting home SHS exposure and "biomarker feedback" of child ingestion of tobacco toxins, that is, objective, laboratory-based results of assays performed on child urine, documenting levels of nicotine; cotinine; and NNAL (4-[methylnitrosamino]-1-[3-pyridyl]-1-butanol), which is a metabolite of the known tobacco carcinogen NNK (4-[methylnitro-samino]-1-[3-pyridyl]-1-butanone).
Inconsistent classification of unexplained sudden deaths in infants and children hinders surveillance, prevention and research: recommendations from The 3rd International Congress on Sudden Infant and Child Death. Commentary. Goldstein RD, Blair PS, Sens MA, Shapiro-Mendoza CK, Krous HF, Rognum TO, Moon RY. Forensic Sci Med Pathol 2019. doi:10.1007/s12024-019-00156-9
This report details the proceedings conclusions from the 3rd International Congress on Unexplained Deaths in Infants and Children, held November 26-27, 2018 at the Radcliffe Institute at Harvard University. The Congress was motivated by the increasing rejection of the diagnosis Sudden Infant Death Syndrome (SIDS) in the medical examiner community, leading to falsely depressed reported SIDS rates and undermining the validity and reliability of the diagnosis, which remains a leading cause of infant and child mortality. We describe the diagnostic shift away from SIDS and the practical issues contributing to it. The Congress was attended by major figures and opinion leaders in this area from countries significantly engaged in this problem. Four categories (International Classification of Diseases (ICD)-11 categories of MH11, MH12, MH14, PB00-PB0Z) were recommended for classification, and explicit definitions and guidance were provided for death certifiers. SIDS was reframed as unexplained sudden death in infancy or SIDS/MH11 to emphasize that either term signifies the lack of explanation following a rigorous investigation. A distinct category for children over the age of 1 was recommended (MH12). Definitions and exclusions were provided for the alternative categories of accidental asphyxia and undetermined. As recommended, unexplained sudden death in infancy or SIDS on a death certificate will code a unique, trackable entity, accurately reflecting the inability to determine a definitive explanation, while satisfying surveillance needs and reliable identification for research efforts. The conclusions will be submitted to the World Health Organization for inclusion in the upcoming ICD-11.
Polymorphisms in the myeloid differentiation primary response 88 pathway do not explain low expression levels in sudden infant death syndrome. Bjørnvall CD, Opdal SH, Rognum TO, Ferrante L. Acta Paediatr 2019; 108 (7): 1262-1266. doi:10.1111/apa.14696
The results showed that none of the genetic variants selected from the MyD88 pathway were associated with neither SIDS nor infectious death. Most of the rare genetic variants were homozygote for the common allele in all groups, while the rest revealed allelic variation.
Global trends in the extent of death scene investigation performed for sudden and unexpected death of infant (SUDI) cases: A systematic review. Bennett T, Martin LJ, Heathfield LJ. Forensic Sci Int 2019; 301: 435-444. doi:10.1016/j.forsciint.2019.06.013
A systematic review was conducted to review the scope of death scene investigation of SUDI cases worldwide. Overall, where a standardised death scene investigation was performed, it added value to the post-mortem investigation; as such, death scene investigation should be encouraged in SUDI investigation. To this end, protocols should be established nationally, and contain core analyses, which could be expanded depending on the needs and resources of the country.
Breastfeeding duration and infant sleep location in a cohort of volunteer breastfeeding counselors. Bailey C, Tawia S, McGuire E. J Hum Lact 2019: 890334419851801. doi:10.1177/0890334419851801
Breastfeeding targets have been difficult to achieve globally, and innovative ideas are required to improve breastfeeding outcomes through public health messaging. There was a strong association in the current study between breastfeeding outcomes and degree of closeness of the infant to the mother at night. This finding should be brought into the discourse on breastfeeding and infant sleep arrangements, accompanied by evidence-based advice about safe sleeping and the promotion of breastfeeding.
USA's experience with sudden unexpected infant death and sudden death in the young case registries. Shapiro-Mendoza CK, Cottengim C. Arch Dis Child 2019; pii: archdischild-2019-317205. doi:10.1136/archdischild-2019-317205
The extent to which laws and mandates that facilitate investigations and autopsies in England and how often they are practised and enforced will be important for the English registry to examine. The US CDC and NIH look forward to partnering with and learning from data captured in England’s and other national sudden death registries.
Origins of disparities in preventable child mortality in England and Sweden: a birth cohort study. Zylbersztejn A, Gilbert R, Hjern A, Hardelid P. Arch Dis Child 2019; pii: archdischild-2018-316693. doi:10.1136/archdischild-2018-316693
Birth cohort study using linked administrative health databases from England and Sweden. Interventions that improve maternal health before and during pregnancy to reduce the prevalence of adverse birth characteristics and address poverty could reduce child mortality due to RTIs and SUDIs in England.
Content of infant safe sleep counseling and maternal reported practices in an urban clinic. Burrell TD, McDonald EM, Mahoney P, Musci RJ, Shields W, Gielen A, Solomon BS. Acad Pediatr 2019; 19 (7): 801-807. doi:10.1016/j.acap.2019.06.014
We described the content of safe sleep counseling by pediatric providers and examined pediatric provider and caregiver factors that may be related to the delivery of safe sleep counseling. Pediatric provider counseling on safe sleep is inconsistent across AAP recommendations demonstrating a need for enhanced provider education and a more standardized approach to assess infant sleep practices.
Evaluation of the presence and distribution of leptomeningeal inflammation in SIDS/SUDI cases and comparison with a hospital-based cohort. Jack E, Haas E, Haddix TL. Childs Nerv Syst 2019. doi:10.1007/s00381-019-04268-z
This study further elucidates the relevance of the presence of inflammatory cells and iron in the leptomeninges. Whether in a hospital-based or more forensically relevant population, the presence of inflammatory cells in the leptomeninges (even in great abundance) is common.
Obstructive sleep apnea and sleep position: does it matter for infants with a cleft palate? Greenlee CJ, Scholes MA, Gao D, Friedman NR. Cleft Palate Craniofac J 2019; 56 (7): 890-895. doi:10.1177/1055665618817664
There were no significant improvements in OSA metrics during nonsupine sleep in infants with CP ± L. Prior to recommending nonsupine positioning which increases infant's exposure to sudden infant death syndrome risk, we advocate obtaining a PSG to verify an objective improvement in OSA.
Observed compliance with safe sleeping guidelines in licensed childcare services. Staton S, Pattinson C, Smith S, Pease A, Blair P, Young J, Irvine S, Thorpe K. Arch Dis Child 2019; pii: archdischild-2019-317000. doi:10.1136/archdischild-2019-317000
Despite 25 years of public health messaging, non-compliance with safe sleeping guidelines was observed to be high in (Australian) childcare services. Understanding of the reasons underlying non-compliance, particularly in contexts were legislative mandate and access to information regarding safe sleeping is high, is critical to informing ongoing public health messaging and should be the focus of future studies.
An evaluation of pathologists' application of the diagnostic criteria from the San Diego definition of SIDS and unclassified sudden infant death. Shipstone RA, Young J, Thompson JMD, Byard RW. Int J Legal Med 2019. doi:10.1007/s00414-019-02126-w
This study demonstrates that with clear guidelines for interpretation, the San Diego definition can be applied reliably, with discrepancies resolved through a process of peer review.
Sudden infant death syndrome (SIDS) and the routine otoacoustic emission infant hearing screening test: an epidemiological retrospective case-control study. Blair PS, Rubens D, Pease A, Mellers D, Ingram J, Ewer AK, Cohen MC, Sidebotham P, Ward Platt M, Coombs R, Davis A, Hall A, Fleming P. BMJ Open 2019; 9 (7): e030026. doi:10.1136/bmjopen-2019-030026
Retrospective case-control study, UK. Otoacoustic emission (OAE) signal recordings were not associated with an increased risk of SIDS. The strongest predictors of SIDS were bed-sharing in hazardous (infant sleeping next to a carer who smoked, drank alcohol or slept on a sofa) circumstances (35% vs 3% controls, p<0.0001), infants found prone (33% vs 3% controls, p<0.0001) and infants whose health in the final week was 'not good' (53% vs 9% controls, p<0.0001).
Sudden infant death syndrome: Do parents follow the recommendations? [Spanish] Ruiz Botia I, Cassanello Peñarroya P, Díez Izquierdo A, Martínez Sánchez JM, Balaguer Santamaria A. An Pediatr (Barc) 2019; pii: S1695-4033(19)30251-6. doi:10.1016/j.anpedi.2019.06.011
The objective of this study is to describe the prevalence of prone position during sleep as well as other risk factors associated with SIDS in a sample of Spanish babies and infants. There is a high prevalence of modifiable risk factors for SIDS among the studied population. Personalized education should be promoted, along with other campaigns to raise awareness and prevent SIDS.
Monitoring of chemical risk factors for sudden infant death syndrome (SIDS) by hydroxyapatite-graphene-MWCNT composite-based sensors. Sudhan N, Lavanya N, Leonardi SG, Neri G, Sekar C. Sensors (Basel) 2019; 19 (15). pii: E3437. doi:10.3390/s19153437
The high performances of the developed sensors make them suitable for monitoring unhealthy actions (e. g. smoking, drinking coffee) in breastfeeding women and environmental factors (bad air quality), which are associated with an enhanced risk for SIDS.
The serotonin brainstem hypothesis for the sudden infant death syndrome. Kinney HC, Haynes RL. J Neuropathol Exp Neurol 2019; 78 (9): 765-779. doi:10.1093/jnen/nlz062
The serotonin brainstem hypothesis has been a leading hypothesis for SIDS over the last 2 decades. Our laboratory has studied this hypothesis over time with a variety of tissue techniques, including tissue receptor autoradiography, high performance liquid chromatography, Western blot analysis, immunocytochemistry, and proteomics. The purpose of this article is to review the progress in our laboratory toward supporting this hypothesis. We conclude that an important subset of SIDS infants has serotonergic abnormalities resulting from a "core lesion" in the medullary reticular formation comprised of nuclei that contain serotonin neurons. This lesion could lead to a failure of protective brainstem responses to homeostatic challenges during sleep in a critical developmental period which cause sleep-related sudden death.
Physicians' knowledge and practice of safe sleep recommendations for infants in South Dakota. Angal J, Gogoi M, Zenel J, Elliott AJ. S D Med 2019; 72 (8): 349-353.
Despite the knowledge of SIDS risk factors, gaps were seen in dissemination of information regarding all risk factors to parents. While sleep position, postnatal exposures and breast feeding were more likely to be addressed, other elements of a safe sleep environment such as bedding surface, bed sharing, pacifier use and room ventilation were less likely to be covered. These findings indicate the need for improved health care provider education/communication in South Dakota.
SIDS, BRUE, and safe sleep guidelines. Behnam-Terneus M, Clemente M. Pediatr Rev 2019; 40 (9): 443-455. doi:10.1542/pir.2017-0259
In 2016, the American Academy of Pediatrics (AAP) published a clinical practice guideline in which they recommended redefining apparent life-threatening event with the more specific term brief resolved unexplained event (BRUE). The purpose of this review is to detail how to apply the BRUE classification guidelines in practice. The recently updated AAP guidelines for sudden infant death syndrome prevention and safe infant sleeping environment are also discussed.
Sleep-related risk and worrying behaviours: a retrospective review of a tertiary centre's experience. Vigo A, Noce S, Costagliola G, Bruni O. Eur J Pediatr 2019. doi:10.1007/s00431-019-03460-2
This retrospective study aims at helping physicians select babies considered at risk for fatal events during sleep. It does so by describing the clinical features and outcome of worrying infants' behaviour during sleep, with the activation of an emergency medical service and/or emergency department, subsequently referred to the Centre for Paediatric Sleep Medicine and sudden infant death syndrome, Regina Margherita Children's Hospital, Turin, Italy.
Ambient air pollution and sudden infant death syndrome in Korea: a time-stratified case-crossover study. Hwang MJ, Cheong HK, Kim JH. Int J Environ Res Public Health 2019; 16 (18). pii: E3273. doi:10.3390/ijerph16183273
In this study, we aimed to estimate the risk of SIDS in relation to exposure to air pollution and the effects of its modifying factors. A mortality dataset with supplementary infant mortality survey data from Statistics Korea was used and combined the concentration of ambient air pollution data from AirKorea based on the date of death and residential addresses of the SIDS cases. In females, an increase in NO2 and CO levels was associated with a higher risk of SIDS in low-birthweight and preterm infants. The OR per 15.7 ppb increment in NO2 was highest among preterm infants, with a value of 5.12 (95% CI: 1.27-20.63), and low-birthweight individuals, with a value of 4.11 (95% CI: 1.74-9.72), at a moving average of 0 to 3 days. In males, however, no significant association was found. In the present study, exposure to air pollution was associated with an increased risk of SIDS. This association was more evident in susceptible infants with a low-birthweight or in cases of preterm birth.
Carbon dioxide rebreathing induced by crib bumpers and mesh liners using an infant manikin. Maltese MR, Leshner M. BMJ Paediatr Open 2019; 3 (1): e000374. doi:10.1136/bmjpo-2018-000374
This study characterises CO2 rebreathing in crib bumpers, mesh liners and other products used to mitigate the crib-to-baby interaction. Product permeability, which has been proposed as a regulatory metric, is not an adequate predictor of CO2 rebreathing. The seal and penetration force are important factors as found in mattresses and other bedding materials by previous authors.
Implications of mothers' social networks for risky infant sleep practices. Moon RY, Carlin RF, Cornwell B, Mathews A, Oden RP, Cheng YI, Fu LY, Wang J. J Pediatr 2019: S0022-3476(19)30593-1. doi:10.1016/j.jpeds.2019.05.027
A prospective cohort of mothers with infants <6 months of age were recruited from January 2015 to December 2016. Mothers completed a survey about their personal social networks and infant care practices. Both the type of networks mothers have, and the norms regarding infant sleep practices that circulate within these networks differed by race. Network norms were strongly associated with infant sleep practices and may partially explain the racial disparity therein.
An integrated analysis of maternal-infant sleep, breastfeeding, and Sudden Infant Death Syndrome research supporting a balanced discourse. Marinelli KA, Ball HL, McKenna JJ, Blair PS. J Hum Lact 2019: 890334419851797. doi:10.1177/0890334419851797
The aims of this integrated analysis were to (a) review breastfeeding and maternal and infant sleep research literature via historical, epidemiological, anthropological, and methodological lenses; (b) use this information to determine where we are currently in safeguarding both infant lives and breastfeeding; and (c) postulate the direction that research might take from this point forward to improve our knowledge and inform our policy and practice.
Prevalence and associated factors of supine sleep position in 3-month-old infants: findings from the 2015 Pelotas (Brazil) birth cohort. da Silva BGC, da Silveira MF, de Oliveira PD, Domingues MR, Neumann NA, Barros FC, Bertoldi AD. BMC Pediatr 2019; 19 (1): 165. doi:10.1186/s12887-019-1534-3
The aim of this study was to assess the prevalence of supine sleep position and associated factors among 3-month-old infants from a birth cohort in the city of Pelotas, southern Brazil. Among the 4108 infants assessed in this study, 2274 (55.4%) slept in supine position at 3 months and only 66 (1.6%) in prone position. Maternal white skin color, higher family income and maternal schooling, advanced maternal age, maternal cohabiting with a partner, receiving counseling from health care professionals and non-bed-sharing were associated with higher prevalence of infants sleeping in supine position at 3 months.
Ethnic and socioeconomic variation in cause-specific preterm infant mortality by gestational age at birth: national cohort study. Kroll ME, Kurinczuk JJ, Hollowell J, Macfarlane A, Li Y, Quigley MA. Arch Dis Child Fetal Neonatal Ed 2019: fetalneonatal-2018-316463. doi:10.1136/archdischild-2018-316463
Ethnic and socioeconomic variation in cause-specific infant mortality of preterm babies by gestational age at birth, in England and Wales 2006-2012. Risks of death from congenital anomalies and combined rarer causes (infection, intrapartum conditions, SIDS and unclassified) increased with deprivation, the rate ratios comparing the most with the least deprived quintile being, respectively, 1.54 (1.22 to 1.93) and 2.05 (1.55 to 2.72). Gestation-specific preterm infant mortality shows contrasting ethnic patterns of death from immaturity-related conditions in extremely-preterm babies, and congenital anomalies in moderate/late-preterm babies. Socioeconomic variation derives from congenital anomalies and rarer causes in moderate/late-preterm babies. Future research should examine biological origins of extremely preterm birth.
The EASE project revisited: improving safe sleep practices in Ohio birthing and children's hospitals. Macklin JR, Gittelman MA, Denny SA, Southworth H, Arnold MW. Clin Pediatr (Phila) 2019: 9922819850461. doi:10.1177/0009922819850461
USA: The objective was to implement a quality improvement program to improve compliance with appropriate safe sleep practices in both children's and birthing hospitals. Each site implemented 3 PDSA (Plan-Do-Study-Act) cycles to improve safe sleep behaviors. A total of 37.0% of infants in children's hospitals were observed to follow the current American Academy of Pediatrics recommendations at baseline; compliance improved to 59.6% at the project's end ( P < .01). Compliance at birthing centers was 59.3% and increased to 72.5% ( P < .01) at the collaborative's conclusion.
Baby box distributions: public health benefit or concern? Middlemiss W, Brownstein NC, Leddy M, Nelson S, Manchiraju S, Grzywacz JG. Public Health Rep. 2019: 33354919847731. doi:10.1177/0033354919847731
Reducing the high number of sleep-related infant deaths in the United States (3700 deaths in 2015, or approximately 90 deaths per 100 000 live births) is the primary motivation for distributing baby boxes. However, empirical evidence documenting the effectiveness of a cardboard baby box either as a safe sleep space or a means of decreasing sleep-related infant deaths is absent from the literature. This absence of scientific evidence of the safety and effectiveness of the baby box for reducing sleep-related infant deaths raises 2 questions: "What is driving distribution?" and "What are the potential concerns?"
Epidemiology of sudden unexpected death in infancy in Argentina: secular trend and spatial variation. Chapur VF, Alfaro EL, Bronberg R, Dipierri JE. Arch Argent Pediatr 2019; 117 (3): 164-170. doi:10.5546/aap.2019.eng.164
Describes the spatial and temporal variation of SUDI in Argentina between 1991 and 2014. The proportion of SUDI and its causes show inter-regional heterogeneity; codes related to inaccurate diagnoses predominated in more unfavorable regions, while sudden infant death syndrome was prevalent in the more developed regions.
The use of post-mortem lividity to determine sleep position in sudden unexpected deaths in infancy. Shipstone R, Thompson JMD, Young J, Byard RW. Acta Paediatr 2019. doi:10.1111/apa.14834
Compares parental reports of position found in sudden unexpected deaths in infancy (SUDI) to autopsy reports of lividity and to more accurately classify infant sleep position. There was a discordance between the position an infant was reported to have been found and the position of lividity at autopsy in 22/228 SUDI (9.6%). All infants had anterior lividity despite 13 reportedly found supine, three on their side and six in an unknown position. Using anterior lividity at autopsy to change the position found increased the proportion of prone infants from 37.7% to 47.4%. Previously published odds ratios may have underestimated the risk of sudden infant death associated with prone sleep position. SUDI death scene investigation protocols should require photographic documentation of lividity prior to transporting an infant.
Reappraisal of variants previously linked with Sudden Infant Death Syndrome: results from three population-based cohorts. Paludan-Müller C, Ghouse J, Vad OB, Herfelt CB, Lundegaard P, Ahlberg G, Schmitt N, Svendsen JH, Haunsø S, Bundgaard H, Hansen T, Kanters JK, Olesen MS. Eur J Hum Genet 2019. doi:10.1038/s41431-019-0416-3
"The study aimed to investigate the pathogenicity of cardiac ion channel variants previously associated with SIDS. Of the 92 SIDS-associated variants, 59 (64%) were present in ExAC, 18 (20%) in Inter99, and 24 (26%) in UKBB. Using the Inter99 cohort, we found no difference in J-point amplitude and QTc-interval between carriers and non-carriers for 14/18 variants. There was no difference in the risk of syncope (P = 0.32), malignant ventricular arrhythmia (P = 0.96), and all-cause mortality (P = 0.59) between carriers and non-carriers. The ACMG guidelines reclassified 75% of all variants as variant-of-uncertain significance, likely benign, and benign. We identified ~2/3 of variants previously associated with SIDS and found no significant associations with electrocardiographic traits, syncope, malignant ventricular arrhythmia, or all-cause mortality. These data indicate that many of these variants are not highly penetrant, monogenic causes of SIDS and underline the importance of frequent reappraisal of genetic variants to avoid future misdiagnosis."
Is prone sleeping dangerous for neonates? Polysomnographic characteristics and NDN gene analysis. Wong SB, Zhao LL, Chuang SH, Tsai WH, Yu CH, Tsai LP. Ci Ji Yi Xue Za Zhi 2019; 31 (2): 113-117. doi:10.4103/tcmj.tcmj_29_18
In this study, daytime polysomnography (PSG) data from 17 neonates aged 2-3 days during supine and prone sleep were reported and the NDN gene, an important gene for neonatal respiratory control, was sequenced for correlation with neonatal respiratory parameters. Heart rate (HR), oxygen saturation, carbon dioxide concentration, sleep stages, central apnea index (CAI), obstructive apnea/hypopnea index (OAHI), and oxygen nadir were compared between supine and prone sleep and between participants with different single-nucleotide polymorphisms (SNPs) in the NDN gene. Tachycardia and respiratory instability were recorded in neonates during prone sleep, suggesting that neonates are vulnerable to cardiopulmonary events during prone sleep. Therefore, young neonates should be kept in the supine sleep position unless there are contraindications.
National registry for sudden unexpected deaths of infants and children in England: why do we need one and do families want one? Review. Matthews E, Blair P, Sisodiya S, Jones S, Sebire N, Behr E, Fleming P. Arch Dis Child 2019: archdischild-2018-316542. doi:10.1136/archdischild-2018-316542
Detailed controlled observational studies of infant deaths identifying risk factors and providing evidence-based advice for parents has seen a dramatic reduction in incidence over the last 30 years by almost 80% but greater knowledge is needed if future deaths of infants and older children are to be prevented and families optimally supported. We propose that a national registry of sudden unexpected deaths in infancy and childhood would accurately determine incidence, identify unknown risk factors and highlight good care practices, ensuring these can be standardised nationally. For such a project to be successful, however, parents must be at the heart of it. We held a consultation day between families, professionals and supporting charities (The Lullaby Trust, Child Bereavement UK, SUDC UK and CRY) to seek opinion on the desire for a registry and how best to ensure families are engaged. Here, we summarise our rationale for a registry and the feedback we received from attendees regarding their views of the proposal and the practical aspects of administering it.
Mechanisms underlying a critical period of respiratory development in the rat. Review. Wong-Riley MTT, Liu Q, Gao X. Respir Physiol Neurobiol 2019; 264: 40-50. doi:10.1016/j.resp.2019.04.006
Against several expected trends of development, abrupt neurochemical, metabolic, ventilatory, and electrophysiological changes occur in the respiratory system at P12-13. This results in a transient synaptic imbalance with suppressed excitation and enhanced inhibition, and the response to acute hypoxia is the weakest at this time, both at the cellular and system's levels. The basis for the synaptic imbalance is likely to be contributed by a reduced expression of brain-derived neurotrophic factor (BDNF) and its TrkB receptors in multiple brain stem respiratory-related nuclei during the critical period. Exogenous BDNF or a TrkB agonist partially reverses the synaptic imbalance, whereas a TrkB antagonist accentuates the imbalance. A transient down-regulation of pituitary adenylate cyclase-activating polypeptide (PACAP) at P12 in respiratory-related nuclei also contributes to the vulnerability of this period. Carotid body denervation during this time or perinatal hyperoxia merely delays and sometimes prolongs, but not eliminate the critical period. The rationale for the necessity of the critical period in postnatal development is discussed.
Nurses leading safe infant sleep initiatives in the hospital setting. Hitchcock SC, Ruhl C. Nurs Womens Health 2019; 23 (2): 148-162. doi:10.1016/j.nwh.2019.02.003
"In birthing hospitals, many parents report being given incorrect and sometimes no information about infant sleep safety, which creates immediate and long-term safety concerns. In this article, we provide an overview of sudden unexpected infant death, including sudden unexpected postnatal collapse, and the latest safe sleep recommendations from the American Academy of Pediatrics. We also offer practical guidelines for nurses-those working at the bedside and those in leadership positions-who may be seeking to improve the quality of infant sleep practices in their organizations."
Sudden Infant Death Syndrome: current perspectives. Horne RSC. Intern Med J 2019; 49 (4): 433-438. doi:10.1111/imj.14248
This review outlines the evidence behind current SIDS risk reduction recommendations.
In utero exposure to nicotine abolishes the postnatal response of the cardiac sodium current to isoproterenol in newborn rabbit atrium. Biet M, Ton AT, Delabre JF, Morin N, Dumaine R. Heart Rhythm 2019; 16 (4): 494-501. doi:10.1016/j.hrthm.2019.02.013
"We provide the first evidence linking fetal exposure to nicotine to long-term alterations of INa response to isoproterenol. These changes may impair INa adaptation to sympathetic tone and prevent awakening from sleep apnea, thus leading to arrhythmias that could potentially be involved in SIDS. Our data also raise concerns about the use of nicotine replacement therapies for pregnant women."
Impaired CO2-Induced Arousal in SIDS and SUDEP. Review. Buchanan GF. Trends Neurosci 2019; 42 (4): 242-250. doi:10.1016/j.tins.2019.02.002
Circumstances surrounding SIDS and SUDEP deaths often facilitate CO2 elevation, and faulty CO2 arousal mechanisms could, at least in part, contribute to death.
Continuing major inconsistencies in the classification of unexpected infant deaths. Byard RW, Shipstone RA, Young J. J Forensic Leg Med 2019; 64: 20-22. doi:10.1016/j.jflm.2019.03.007
The classification of the cause of unexpected infant deaths by both pathologists and researchers may be quite inconsistent. For example, if an infant is found lying face down on soft bedding the death may still be certified as 'sudden infant death syndrome (SIDS)', 'accidental suffocation', 'undetermined', 'unclassified sudden infant death (USID)', or 'sudden unexpected death in infancy (SUDI)'. As the San Diego definition of SIDS does not appear to be rigorously or consistently applied, clarifying 'mechanical asphyxia not determined with certainty' may help to more clearly separate SIDS from USID. Including a classification algorithm with the definition may also help to better define unsafe sleep factors and suffocation. This commentary reviews the current situation with regard to classifying these deaths and concludes that the absence of diagnostic pathological markers with conflicting classification systems has led to idiosyncratic certification practices.
In vitro analyses of suspected arrhythmogenic thin filament variants as a cause of sudden cardiac death in infants. Shafaattalab S, Li AY, Lin E, Stevens CM, Dewar LJ, Lynn FC, Sanatani S, Laksman Z, Morin RD, van Petegem F, Hove-Madsen L, Tieleman DP, Davis JP, Tibbits GF. Proc Natl Acad Sci U S A. 2019; 116 (14): 6969-6974. doi:10.1073/pnas.1819023116
To investigate the genetic pathogenesis of SUDI, we sequenced >70 genes from 191 autopsy-negative SUDI victims. The approach used in this study provides critical physiological and mechanistic bases to investigate sarcomeric mutations in the pathogenesis of SUDI.
Increased central cholinergic drive contributes to the apneas of serotonin-deficient rat pups during active sleep. Davis MR, Magnusson JL, Cummings KJ. J Appl Physiol (1985) 2019; 126 (5): 1175-1183. doi:10.1152/japplphysiol.00909.2018
Serotonin in the central nervous system (CNS) is necessary for maintaining the stability of breathing in the early postnatal period, particularly during active sleep. Here we show that the administration of atropine to the CNS selectively stabilizes the respiratory pattern of tryptophan hydroxylase 2-deficient rat pups and reduces their apneas. This suggests that CNS serotonin stabilizes breathing at least in part by reducing central cholinergic drive.
Impaired neonatal cardiorespiratory responses to hypoxia in mice lacking PAC1 or VPAC2 receptors. Barrett KT, Hasan SU, Scantlebury MH, Wilson RJA. Am J Physiol Regul Integr Comp Physiol 2019; 316 (5): R594-R606. doi:10.1152/ajpregu.00250.2018
The stress peptide pituitary adenylate cyclase activating polypeptide (PACAP) and its specific receptor PACAP type 1 receptor (PAC1) have been implicated in sudden infant death syndrome (SIDS). PACAP is also critical to the neonatal cardiorespiratory response to homeostatic stressors identified in SIDS, including hypoxia. However, which of PACAP's three receptors, PAC1, vasoactive intestinal peptide receptor type 1 (VPAC1), and/or vasoactive intestinal peptide receptor type 2 (VPAC2), are involved is unknown. These findings suggest that PAC1 plays the principal role in mediating the cardiorespiratory effects of PACAP in response to hypoxic stress during neonatal development and that defective PACAP signaling via PAC1 may contribute to the pathogenesis of SIDS.
The α3 and α4 nicotinic acetylcholine receptor (nAChR) subunits in the brainstem medulla of sudden infant death syndrome (SIDS). Aishah A, Hinton T, Waters KA, Machaalani R. Neurobiol Dis 2019; 125: 23-30. doi:10.1016/j.nbd.2019.01.010
Abnormalities in nicotine receptor binding and in the expression of the nicotinic acetylcholine receptor (nAChR) subunits α7 and β2 have been reported in the brainstem of SIDS infants. This study focuses on the α3 and α4 nAChR subunits as α3 is important for early postnatal survival while α4 is crucial for nicotine-elicited antinociception and sleep-wake cycle regulation. These findings suggest that abnormalities in endogenous acetylcholine synthesis and regulation may underlie the altered α3 and α4 nAChR subunit expressions in the SIDS brainstem medulla since the changes were not related to cigarette smoke exposure.
Evidence for an association of interferon gene variants with Sudden Infant Death Syndrome. Hafke A, Schürmann P, Rothämel T, Dörk T, Klintschar M. Int J Legal Med 2019; 133 (3): 863-869. doi:10.1007/s00414-018-1974-6
This large study of 251 SIDS cases for common variants in 13 candidate genes governing the immune system has provided first evidence for a role of IFNG in the etiology of SIDS and should stimulate further research into the clinicopathological relevance of immunomodulatory genes for this fatal syndrome.
Aerodynamic factors affecting rebreathing in infants. Itzhak N, Greenblatt D. J Appl Physiol (1985) 2019; 126 (4): 952-964. doi:10.1152/japplphysiol.00784.2018
A fundamentally new aerodynamics-based approach to the study of rebreathing of expired air in infants is presented. Rebreathing is implicated in unexplained Sudden Infant Death Syndrome (SIDS) when infants sleep in a prone position. This is the first time that aerodynamic parameters are systematically varied and their effects on rebreathing quantified. The study provides us with a deeper understanding of the effects of breathing frequency, tidal volume (birthweight) and environmental conditions.
Infants who die in shared sleeping situations differ from those who die while sleeping alone. Review. Collins-Praino LE, Byard RW. Acta Paediatr 2019; 108 (4): 611-614. doi:10.1111/apa.14692
Literature review investigating differences between infants who are sharing a sleeping surface with others, compared to those who die alone. The results demonstrate differences between infants who are sharing a sleeping surface with others, compared to those who die alone. It is likely, therefore, that lethal mechanisms for some shared sleepers are not the same as for SIDS infants sleeping alone, and may involve suffocation.
Sudden unexpected infant death characteristics in the French region of West Provence-Alpes-Côte d'Azur. Tuchtan L, Delteil C, Levrat F, Bacquet J, Garcia P, Fayol L, Gorincour G, Zandotti C, Girard N, Drancourt M, Léonetti G, Piercecchi Marti MD, Bartoli C. Paediatr Int Child Health 2019; 39 (2): 104-110. doi:10.1080/20469047.2018.1533734
Asymptomatic infectious conditions were associated with a high proportion of SUID cases. Non-supine sleep positions were still practised. There is a need to increase SUID prevention campaigns.
Neuropathology of early Sudden Infant Death Syndrome - hypoplasia of the pontine kolliker-fuse nucleus: a possible marker of unexpected collapse during skin-to-skin care. Lavezzi AM, Ferrero S, Paradiso B, Chamitava L, Piscioli F, Pusiol T. Am J Perinatol 2019; 36 (5): 460-471. doi:10.1055/s-0038-1669398
The delayed development of the KFN could represent a specific finding of eSIDS occurring during SSC. Therefore, it is necessary to point out that the SSC represents a further risk factor that must be added to others already known for sudden infant death syndrome. Then this practice needs appropriate monitoring strategies of the infant's conditions.
Sudden Infant Death Syndrome: a global public health issue and nursing's response. Pretorius K, Rew L. Compr Child Adolesc Nurs 2019; 42 (2): 151-160. doi:10.1080/24694193.2018.1451569
"In this article, we review SIDS, describe nursing's unique professional position in addressing this problem, and explore how the principles of social justice can inform nursing's response. Motivated by nursing's ethical and moral obligations, the profession is called to take an active role in educating others regarding this phenomenon, to participate in research, and to develop or advocate for policy that aims to reduce the incidence of SIDS on an international scale."
Sudden Infant Death Syndrome: the role of multidisciplinary teams. Experience of the SIDS-ALTE center of Liguria region. Review. Palmieri A, Fulcheri E, Nozza P, Ceriolo P, Aiello C, Ferrando A, Costabel S, Morasso S, Caglieris S, Ventura F. Minerva Pediatr 2019; 71 (2): 196-200. doi:10.23736/S0026-4946.18.04971-X
Italy: "The aim of this paper was to highlight the importance of a multidisciplinary and multiprofessional management of SIDS for a complete approach to this tragic event. Both biomedical and psychosocial aspects are evaluated, focusing on the impact of SIDS diagnosis on the family. The paper describes the organization of our team, composed of a network of specialists involved in both prevention and management of SIDS. A protocol is proposed to improve SIDS diagnosis and management. In our team, the clinical pediatrician is the coordinator of specialists and the mediator between the family and the other specialists, thanks to his direct relationship with parents."
Conversations with families about reducing the risk of sudden infant death syndrome. Review. Pease A, Blair P, Ingram J, Fleming P. J of Health Vis 2019; 7 (5): 226-231. doi:10.12968/johv.2019.7.5.226
Inequalities in the burden of sudden and unexpected deaths in infancy make targeted action by health professionals a viable option for intervention. Most of the deaths that now occur have at least one known modifiable risk factor present, so the potential impact of supporting families with implementing safer sleep strategies is great and may bring about a further reduction in infant deaths. This article describes the latest evidence for action on three of the major risk factors for SIDS: sleeping position; smoking; and co-sleeping. It goes on to discuss how to translate this evidence into effective communication strategies for families, including giving information about why or how the messages increase safety for sleeping babies.
The Sudden Infant Death Syndrome mechanism of death may be a non-septic hyper-dynamic shock. Gabbay U, Carmi D, Birk E, Dagan D, Shatz A, Kidron D. Med Hypotheses 2019; 122: 35-40. doi:10.1016/j.mehy.2018.10.018
A hypothesis for increased CO in conjunction with stressors which may provide a mechanism for death.
The influence of bed-sharing on infant physiology, breastfeeding and behaviour: a systematic review. Baddock SA, Purnell MT, Blair PS, Pease AS, Elder DE, Galland BC. Sleep Med Rev 2019; 43: 106-117. doi:10.1016/j.smrv.2018.10.007
"Objective risk arises if the infant is unable to mount an appropriate physiological or behavioural response to their micro-environment. More studies in the bed-sharing setting are needed to identify infant risk, the potential benefits of a safer environment, and how bed-sharing interacts with infant care practices other than sleep."
Qualitative analysis of serious case reviews into unexpected infant deaths. Garstang JJ, Sidebotham P. Arch Dis Child 2019; 104 (1): 30-36. doi:10.1136/archdischild-2018-315156
"Most SUDI cases occurred in hazardous sleep environments and are potentially preventable. They occurred in families well known to services with concerns about neglect, substance misuse and poor engagement. More consideration is needed on how best to support such vulnerable families."
Neonatal circumcision and prematurity are associated with sudden infant death syndrome (SIDS). Elhaik E. J Clin Transl Res 2019; 4 (2): 136-151. doi:10.18053/jctres.04.201802.005
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. 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. 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.
Maternal smoking before and during pregnancy and the risk of sudden unexpected infant death. Anderson TM, Lavista Ferres JM, Ren SY, Moon RY, Goldstein RD, Ramirez JM, Mitchell EA. Pediatrics 2019: e20183325. doi:10.1542/peds.2018-3325
SUID risk more than doubled (adjusted odds ratio [aOR] = 2.44; 95% confidence interval [CI] 2.31-2.57) with any maternal smoking during pregnancy and increased twofold between no smoking and smoking 1 cigarette daily throughout pregnancy. These data support the need for smoking cessation before pregnancy. If no women smoked in pregnancy, SUID rates in the United States could be reduced substantially.
The association between preterm labour, perinatal mortality and infant death (during the first year) in Bishop Lavis, Cape Town, South Africa. Brink LT, Gebhardt GS, Mason D, Groenewald CA, Odendaal HJ. S Afr Med J. 2019; 109 (2): 102-106. doi:10.7196/SAMJ.2019.v109i2.13438
As part of the Safe Passage Study of the PASS Network in Cape Town, South Africa, the outcomes of 6 866 singleton pregnancies were prospectively followed from recruitment in early pregnancy until the infant was 12 months old to assess pregnancy outcome. Preterm birth and fetal growth restriction play significant roles in fetal, neonatal and infant losses.
Effect of education and cardboard bassinet distribution on newborn bed-sharing. Heere M, Moughan B, Alfonsi J, Rodriguez J, Aronoff S. Glob Pediatr Health 2019; 6: 2333794X19829173. doi:10.1177/2333794X19829173
This study sought to determine if infant sleep education plus a cardboard bassinet reduced bed-sharing, a risk factor for sudden infant death syndrome (SIDS) and sleep-related deaths (SRD), in the first week of life. Bed-sharing rates: Control: 6.3% (5.2,7.4); Intervention: 4.7% (3.5,5.9). Rate ratio (Control/Intervention) was 1.36 (0.95,1.83) and the Bayesian probability that the rate ratio >1 was .96 and .97 by calculation and simulation, respectively. Bed-sharing rates for exclusively breastfed infants: Control: 11% (7.4, 14.6); Intervention: 5.9% (2.7, 9.2); Rate ratio was 2.00 (1.01, 3.15) and the Bayesian probability that the rate ratio >1 was .993. Infant sleep education plus a cardboard bassinet reduced the rate of bed-sharing in the first week of life, particularly among exclusively breastfeeding dyads.
Can we still do something - and what? - for a seemingly missing syndrome? Campi R, Bonati M. Ital J Pediatr 2019; 45 (1): 28. doi:10.1186/s13052-019-0621-2
Italian infant mortality rates were analysed between 1996 and 2015. Interventions that support safe sleep must be maintained, but research is still needed since although these dramatic deaths have been reduced their causes remain unknown. The challenge is now to shift their trend which has been constant for too long.
Impact of a baby-friendly-aligned pacifier policy on pacifier use at 1 month of age. Ekambaram M, Irigoyen MM, Paoletti A, Siddiqui I. Acad Pediatr 2019: S1876-2859(19)30041-5. doi:10.1016/j.acap.2019.02.002
Pacifier use decreases the risk of sudden infant death syndrome, but its impact on breastfeeding remains controversial. A Baby-Friendly-aligned pacifier policy delayed pacifier adoption but did not impact overall pacifier use or breastfeeding rates at 1 month of age. The finding of lower pacifier use rates among female infants post-intervention requires verification in other populations before evaluating public heath relevance.
Can infant sleeping bags be recommended by medical professionals as protection against sudden infant death syndrome? Glover Williams A, Finlay F. Arch Dis Child 2019; 104 (3): 305-307. doi:10.1136/archdischild-2018-316093
Literature review. Sleeping bags are used in 48-95% of infants in the UK and advocated for by the Lullaby Trust for their safety in the prevention of SIDS. The case control studies included found that sleeping bags are as safe, if not safer than other bedding when examining SIDS as an outcome. For sleeping bags to be safe they must be well made and appropriately used, which includes the correct size, Tog, clothing and other bedding for bedroom temperature.
Implementation of a statewide program to promote safe sleep, breastfeeding and tobacco cessation to high risk pregnant women. Ahlers-Schmidt CR, Schunn C, Engel M, Dowling J, Neufeld K, Kuhlmann S. J Community Health 2019; 44 (1): 185-191. doi:10.1007/s10900-018-0571-4
The purpose of this project was to evaluate outcomes of Safe Sleep Instructor-led community baby showers, which included safe sleep promotion, breastfeeding promotion and tobacco cessation education. Certified Safe Sleep Instructors (n = 35) were trained on how to plan and host a Community Baby Shower to provide education to pregnant women of low socioeconomic status or with high risk of infant mortality. Based on the result of the pre- and post-event surveys, certified Safe Sleep Instructors were able to plan and host successful events to increase knowledge and confidence related to risk reduction strategies to reduce sleep-related infant deaths.
Noncardiac genetic predisposition in Sudden Infant Death Syndrome. Gray B, Tester DJ, Wong LC, Chanana P, Jaye A, Evans JM, Baruteau AE, Evans M, Fleming P, Jeffrey I, Cohen M, Tfelt-Hansen J, Simpson MA, Ackerman MJ, Behr ER. Genet Med 2019; 21 (3): 641-649. doi:10.1038/s41436-018-0131-4
We aimed to identify noncardiac genes underpinning SIDS and determine their prevalence compared with ethnically matched controls. A monogenic basis for SIDS amongst the previously implicated noncardiac genes and their encoded biological pathways is negligible.
A comparison of infant sleep safety guidelines in nine industrialized countries. Doering JJ, Salm Ward TC, Strook S, Campbell JK. J Community Health 2019; 44 (1): 81-87. doi:10.1007/s10900-018-0556-3
All guidelines recommended the supine sleep position and avoidance of smoke exposure. While most guidelines addressed the remaining 11 categories, specific recommendations varied among guidelines. These findings can inform the broad context of SIDS reduction work, offer opportunities for collaboration among countries, and promote multi-country and global conversations about how research evidence is translated into recommendations for practice.
Qualitative analysis of serious case reviews into unexpected infant deaths. Garstang JJ, Sidebotham P. Arch Dis Child 2019; 104 (1): 30-36. doi:10.1136/archdischild-2018-315156
Most SUDI cases occurred in hazardous sleep environments and are potentially preventable. They occurred in families well known to services with concerns about neglect, substance misuse and poor engagement. More consideration is needed on how best to support such vulnerable families.
Tricuspid valve hemangioma associated with hypoplastic left heart syndrome presenting as Sudden Infant Death Syndrome. Gupta B, Ghosh S, Kujur M, Khetan K, Kumar T. Turk Patoloji Derg 2019; 35 (1): 55-57. doi:10.5146/tjpath.2015.01362
Primary cardiac tumors are rare in children with a low incidence varying from 0.0017 to 0.28% in autopsy studies. Approximately 90% of the reported primary cardiac tumors in the pediatric population are benign and the most common subtype is rhabdomyomas accounting for approximately 60%, while hemangiomas are rare primary tumors with a 5% incidence. Hypoplastic left heart syndrome is abnormal development of the left-sided cardiac structures, leading to obstruction of blood flow from the left ventricle out-flow tract. Here we report a case of tricuspid hemangioma in association with hypoplastic left heart syndrome, a rare association not previously reported in the literature.
Brief Resolved Unexplained Event (BRUE). Kondamudi NP, Virji M. StatPearls. Treasure Island (FL, USA): StatPearls Publishing; 2019 Jan - 2018 Oct 27.
The American Academy of Pediatrics published a clinical practice guideline in 2016 recommending replacing the term apparent life-threatening event (ALTE) with a new term named brief resolved unexplained event (BRUE).The diagnosis of brief resolved unexplained event can only be made when there is no explanation for a qualifying event after an appropriate history and physical examination. Review of previous apparent life-threatening event literature reveals that a small subset of infants with a diagnosis compatible with a brief resolved unexplained event may have a serious underlying disease or are prone to recurrent episodes. High-risk infants are those younger than two months of age, those with a history of prematurity (higher in less than 32 weeks gestation), and those with more than one event.
Trends in the incidence of sudden unexpected infant death in the newborn: 1995-2014. Bass JL, Gartley T, Lyczkowski DA, Kleinman R. J Pediatr. 2018; 196: 104-108. doi:10.1016/j.jpeds.2017.12.045
Evaluates the epidemiology of sudden unexpected infant death (SUID) over a 20-year period in the US, to assess the potential frequency of sudden unexpected postnatal collapse in the early days of life, and to determine if SUID rates in the neonatal period (0-27 days) have changed in parallel with rates in the postneonatal periods, including the percentages attributed to codes that include accidental suffocation. Although SUID rates in the postneonatal period have declined subsequent to the 1992 American Academy of Pediatrics sleep position policy change, newborn SUIDs have failed to decrease, and the percentage of SUIDs attributed to unsafe sleep conditions has increased significantly in both periods; 29.2% of the neonatal cases occurred within the first 6 days of life.
Sudden unexpected infant death rates differ by age at death. Letter. Shapiro-Mendoza CK. J Pediatr 2018; 198: 322-325. doi:10.1016/j.jpeds.2018.04.058
Bass et al show that SUID differs by age at death. Understanding factors related to age differences informs interventions. SUID rarely occurs in the neonatal period. Of the 4 million US births in 2015, SUID accounted for 108 deaths at 0-6 days and 314 deaths at 7-27 days. Ongoing surveillance of SUID rates by age at death is important to evaluate the impact of infant care interventions, identify new risk factors, and track progress towards reducing SUID mortality.
SIDS – Sudden infant and early childhood death: The past, the present and the future. Duncan JR, Byard RW (eds). Adelaide, Australia: University of Adelaide Press; 2018. doi:10.20851/sids
Why mainstream SIDS research is not achieving its goal. Goldwater PN. Am J Pediatr 2018; 4 (4): 104-109. doi:10.11648/j.ajp.20180404.16
Creating a safe sleep environment for the infant: what the pediatric nurse needs to know. Newberry JA. J Pediatr Nurs 2019; 44: 119-122. doi:10.1016/j.pedn.2018.12.001
A review article describing the need for pediatric nurses to model safe sleep practices in hospital.
Thymic changes and Sudden Infant Death Syndrome (SIDS). Byard RW. J Forensic Leg Med 2019; 61: 141. doi:10.1016/j.jflm.2018.09.004
Letter to the Editor requesting improved reporting of SIDS classification in research reports.
Infants who die in shared sleeping situations differ from those who die while sleeping alone. Collins-Praino LE, Byard RW. Acta Paediatr 2018 doi:10.1111/apa.14692
A literature review. "The results demonstrate differences between infants who are sharing a sleeping surface with others, compared to those who die alone. It is likely, therefore, that lethal mechanisms for some shared sleepers are not the same as for SIDS infants sleeping alone, and may involve suffocation."
Response to a national issue: moving beyond "Back to Sleep" at three hospitals. Sleutel MR, True B, Gustus H, Baldwin K, Early B. J Pediatr Nurs 2018; 43: 16-22. doi:10.1016/j.pedn.2018.07.013
Longitudinal quasi-experimental study. "An updated educational tool improved nurses' and parents' knowledge and practices related to current and updated safety factors for infant sleep conditions. Inpatient adherence to infant sleep safety recommendations improved."
A systematic review of molecular autopsy studies in Sudden Infant Death Cases. Heathfield LJ, Martin LJ, Ramesar R. J Pediatr Genet 2018; 7 (4): 143-149. doi:10.1055/s-0038-1668079
"Internationally, molecular autopsies have shown to resolve up to 44% of unexplained cases; however, it is currently unclear how many of these were infants. This systematic literature review showed that significantly fewer infant cases were resolved (median: 4%) compared with cohorts of 1 to 45 years old (median: 32%). Further, no study involving indigenous African participants has yet been published. Overall, molecular autopsies hold immense value to living family members and is motivation to explore new avenues in infant cohorts."
Sudden unexpected infant death characteristics in the French region of West Provence Alpes-Côte d'Azur. Tuchtan L, Delteil C, Levrat F, Bacquet J, Garcia P, Fayol L, Gorincour G, Zandotti C, Girard N, Drancourt M, Léonetti G, Piercecchi Marti MD, Bartoli C. Paediatr Int Child Health 2018:1-7. doi:10.1080/20469047.2018.1533734
Anaysis of infant death records. "Asymptomatic infectious conditions were associated with a high proportion of SUID cases. Non-supine sleep positions were still practised. There is a need to increase SUID prevention campaigns."
Preventing Sudden Infant Death Syndrome and other sleep-related infant deaths. Maged M, Rizzolo D. JAAPA 2018; 31 (11): 25-30. doi:10.1097/01.JAA.0000546475.33947.44
Commentary. "This article describes the different types of SUID, associated risk factors, and highlights recommendations to help parents and caregivers ensure safe sleep environments for infants."
Can infant sleeping bags be recommended by medical professionals as protection against Sudden Infant Death Syndrome? Glover Williams A, Finlay F. Arch Dis Child 2018. doi:10.1136/archdischild-2018-316093
Literature review. "The case control studies included found that sleeping bags are as safe, if not safer than other bedding when examining SIDS as an outcome."
Infant and youth mortality trends by race/ethnicity and cause of death in the United States. Khan SQ, Berrington de Gonzalez A, Best AF, Chen Y, Haozous EA, Rodriquez EJ, Spillane S, Thomas DA, Withrow D, Freedman ND, Shiels MS. JAMA Pediatr 2018; 172 (12): e183317. doi:10.1001/jamapediatrics.2018.3317
"Mortality rates in the United States have generally declined for infants and youths from 1999 to 2015 owing to reductions in sudden infant death syndrome, unintentional injury death, and homicides. However, US mortality rates remain higher than Canada and England/Wales, with particularly elevated rates among black and American Indian/Alaskan Native youth."
Exome-wide rare variant analyses in Sudden Infant Death Syndrome. Tester DJ, Wong LCH, Chanana P, Gray B, Jaye A, Evans JM, Evans M, Fleming P, Jeffrey I, Cohen M, Tfelt-Hansen J, Simpson MA, Behr ER, Ackerman MJ. J Pediatr 2018; 203: 423-428. doi:10.1016/j.jpeds.2018.08.011
"The lack of exome-wide significant genetic associations indicates an extreme heterogeneity of etiologies underlying SIDS. Our approach to understanding the genetic mechanisms of SIDS has far reaching implications for the SIDS research community as a whole and may catalyze new evidence-based SIDS research across multiple disciplines. Perturbations in glucocorticoid biosynthesis may represent a novel SIDS-associated biological pathway for future SIDS investigative research."
Sudden unexpected postnatal collapse. Review. Monnelly V, Becher JC. Early Hum Dev 2018; 126: 28-31. doi:10.1016/j.earlhumdev.2018.09.001
"In comparing SUPC with Sudden Unexpected Death in Infancy (SUDI), the potentially avoidable nature of many SUPC is emphasised and the role of positioning and public awareness explored. The article focusses on the implementation of preventative strategies in the immediate postnatal period and the role of therapeutic hypothermia in ameliorating long term neurological injury."
Transient otoacoustic emissions and auditory brainstem responses in low-risk cohort of newborn and one-month-old infants: assessment of infant auditory system physiology in the Prenatal Alcohol in SIDS and Stillbirth Network Safe Passage Study. Sininger YS, Condon CG, Hoffman HJ, Elliott AJ, Odendaal HJ, Burd LL, Myers MM, Fifer WP; PASS Network. J Am Acad Audiol 2018; 29 (8): 748-763. doi:10.3766/jaaa.17043
Normative ABR and TOAE data collected from a cohort of infants at birth and 1 month. Consistent with published reports in the general population.
Neuropathology of early Sudden Infant Death Syndrome-hypoplasia of the pontine Kolliker-Fuse nucleus: a possible marker of unexpected collapse during skin-to-skin care. Lavezzi AM, Ferrero S, Paradiso B, Chamitava L, Piscioli F, Pusiol T. Am J Perinatol 2018. doi:10.1055/s-0038-1669398
Alterations of neuronal structures found in 19/22 early SIDS cases, 11 /12 while on mother’s chest. Concludes that skin to skin care could be a risk factor for early SIDS.
Noncardiac genetic predisposition in Sudden Infant Death Syndrome. Gray B, Tester DJ, Wong LC, Chanana P, Jaye A, Evans JM, Baruteau AE, Evans M, Fleming P, Jeffrey I, Cohen M, Tfelt-Hansen J, Simpson MA, Ackerman MJ, Behr ER.Genet Med 2018. doi:10.1038/s41436-018-0131-4
"A monogenic basis for SIDS amongst the previously implicated noncardiac genes and their encoded biological pathways is negligible."
Sudden infant death and social justice: a syndemics approach. Bartick M, Tomori C. Matern Child Nutr 2018: e12652. doi:10.1111/mcn.12652
"A coordinated emphasis on reducing infant mortality by reducing tobacco use and preterm birth, addressing poverty and disparities, and promoting breastfeeding would be much more effective than addressing SUID and SIDS in isolation."
Retrospective genetic analysis of 200 cases of Sudden Infant Death Syndrome and its relationship with long QT syndrome in Korea. Son MJ, Kim MK, Yang KM, Choi BH, Lee BW, Yoo SH. J Korean Med Sci. 2018; 33 (32): e200. doi:10.3346/jkms.2018.33.e200
"This genetic investigation of LQTS in SIDS showed a low diagnostic yield. These findings suggest that LQTS molecular autopsy could be cautiously conducted in selected cases with family involvement to improve the available genetic counseling information. Meanwhile, a national SIDS registry should be established to document and evaluate the genetic risk of SIDS in Korea."
Eleventh safe sleeping survey in the Netherlands: parents' habits concerning infant sleep position and location [Dutch]. Konijnendijk AAJ, Engelberts AC, L'Hoir MP, Boere-Boonekamp MM. Ned Tijdschr Geneeskd 2018; 162. pii:D2366
Cross-sectional survey. "Parents do not automatically follow safe sleep recommendations for their child. Prevention may be improved by talking to parents about their reasons for not adhering to recommendations and determining together how to create a safe sleeping environment for the baby."
SIDS - sudden infant and early childhood death: the past, the present and the future. Duncan JR, Byard RW, editors. Adelaide (Australia): University of Adelaide Press; 2018. Book in PDF.
Textbook. "This volume covers aspects of sudden infant and early childhood death, ranging from issues with parental grief, to the most recent theories of brainstem neurotransmitters. It also deals with the changes that have occurred over time with the definitions of SIDS (sudden infant death syndrome), SUDI (sudden unexpected death in infancy) and SUDIC (sudden unexpected death in childhood)."
The effects of sleeping position, maternal smoking and substance misuse on the ventilatory response to hypoxia in the newborn period. Rossor T, Ali K, Bhat R, Trenear R, Rafferty G, Greenough A. Pediatr Res. 2018; 84(3): 411-418. doi:10.1038/s41390-018-0090-0
Case-control study of 22 controls, 23 infants whose mothers smoked and 18 whose mothers misused substances and smoked. "The altered response to hypoxia in the prone position of infants whose mothers substance-misused and smoked in pregnancy may explain their increased vulnerability to SIDS."
Ethnic variation in unexplained deaths in infancy, including sudden infant death syndrome (SIDS), England and Wales 2006-2012: national birth cohort study using routine data. Kroll ME, Quigley MA, Kurinczuk JJ, Dattani N, Li Y, Hollowell J. J Epidemiol Community Health 2018; 72 (10): 911-918. doi:10.1136/jech-2018-210453
"Crude rates per 1000 live singleton births were as follows: 0.1-0.2 for Indian, Bangladeshi, Pakistani, White Non-British, Black African; 0.4 for White British; 0.6-0.7 for Mixed Black-African-White, Mixed Black-Caribbean-White, Black Caribbean. […] Substantial ethnic disparity in risk of unexplained infant death exists in England and Wales. Apparently not attributable to preterm birth or area deprivation, this may reflect cultural differences in infant care. Further research into infant-care practices in low-risk ethnic groups might enable more effective prevention of such deaths in the general population."
Caring about preemies' safe sleep (CaPSS): an educational program to improve adherence to safe sleep recommendations by mothers of preterm infants. Dowling DA, Barsman SG, Forsythe P, Damato EG. J Perinat Neonatal Nurs 2018; 32 (4): 366-372. doi:10.1097/JPN.0000000000000345
Pilot of an online education module for improving safe sleep for premature babies.
Evaluation of nursing school educators' knowledge and attitudes regarding infant sleep safety. Cirelli J, Clymer B, Burgess A, Aguilar J, Bell T, Goodstein M. Nurs Educ Perspect 2018; 39 (4): E7-E13. doi:10.1097/01.NEP.0000000000000334
Cross-sectional survey. "Of 396 educators surveyed, 70 percent identified all sudden infant death syndrome risk factors. Correct responses for individual safe sleep recommendations ranged from 99 percent for correct room temperature to 53 percent for pacifier use; 9 percent said it was safest for infants to sleep in a position other than on the back."
The potential role of substance P in brainstem homeostatic control in the pathogenesis of Sudden Infant Death Syndrome (SIDS). Bright FM, Vink R, Byard RW. Neuropeptides 2018; 70: 1-8. doi:10.1016/j.npep.2018.02.006
"This review focuses on the pathways within the medulla involving SP and its tachykinin NK1 receptor, their potential relationship with the medullary 5-HT system, and possible involvement in the pathogenesis of SIDS."
Smoking in pregnancy is a key factor for sudden infant death among Māori. MacFarlane M, Thompson JMD, Zuccollo J, McDonald G, Elder D, Stewart AW, Lawton B, Percival T, Baker N, Schlaud M, Fleming P, Taylor B, Mitchell EA. Acta Paediatr 2018; 107 (11): 1924-1931. doi:10.1111/apa.14431
New Zealand case-control study. "The association between known SUDI risk factors, including bed sharing and/or smoking in pregnancy and SUDI risk, is the same regardless of ethnicity. Māori infants are exposed more frequently to both behaviours because of the higher Māori smoking rate."
Sudden Infant Death Syndrome: knowledge and practise in parents of preterm infants. Rohana J, Ishak S, Wan Nurulhuda WMZ. Pediatr Int 2018; 60 (8): 710-713. doi:10.1111/ped.13605
Survey in Kuala Lumpur, Malaysia. "Knowledge on SIDS risk reduction measures was generally poor among parents of preterm infants in this study. Cigarette smoking, bed sharing and non-supine sleep positions, which are associated with increased risk of SIDS, were common practise among the present subjects."
Neuropathological developments in Sudden Infant Death Syndrome. Bright FM, Vink R, Byard RW. Pediatr Dev Pathol 2018; 21 (6): 515-521. doi:10.1177/1093526618776439
"The following overview examines recent research developments looking particularly at the potential role of the peptide neurotransmitter substance P and its neurokinin-1 receptor in multiple nuclei within the brainstem, asymmetry and microdysgenesis of the hippocampus, and decreased orexin levels within dorsomedial, perifornical, and lateral levels in the hypothalamus."
The grief of mothers after the sudden unexpected death of their infants. Goldstein RD, Lederman RI, Lichtenthal WG, Morris SE, Human M, Elliott AJ, Tobacco D, Angal J, Odendaal H, Kinney HC, Prigerson HG; PASS Network. Pediatrics 2018; 141 (5). pii:e20173651. doi:10.1542/peds.2017-3651
"Severe symptoms and heightened risk for PGD (prolonged grief disorder) was seen in mothers after their infants died of SIDS, with discernible symptom profiles. Given their involvement with families after SIDS, pediatricians may have a unique role in identifying this problem and helping address its consequences."
Neuronal noise as an origin of sleep arousals and its role in Sudden Infant Death Syndrome. Dvir H, Elbaz I, Havlin S, Appelbaum L, Ivanov PC, Bartsch RP. Sci Adv 2018; 4 (4): eaar6277. doi:10.1126/sciadv.aar6277
Interesting zebrafish experiment. "Our findings indicate a previously unrecognized neurophysiological mechanism that links sleep arousals with temperature regulation, and may explain the origin of the clinically observed higher risk for sudden infant death syndrome with increased ambient temperature."
Is ambient air pollution associated with onset of sudden infant death syndrome: a case-crossover study in the UK. Litchfield IJ, Ayres JG, Jaakkola JJK, Mohammed NI. BMJ Open 2018; 8 (4): e018341. doi:10.1136/bmjopen-2017-018341
"The results indicated ambient air pollutants, particularly PM10 and NO2, may show an association with increased SIDS mortality."
The impact of health messages on maternal decisions about infant sleep position: a randomized controlled trial. Carlin RF, Abrams A, Mathews A, Joyner BL, Oden R, McCarter R, Moon RY. J Community Health 2018; 43 (5): 977-985. doi:10.1007/s10900-018-0514-0
"Over the first 6 months, the proportion of African-American infants placed supine gradually decreased and was unchanged by enhanced education about SIDS, suffocation risk and sleep safety. While initially high self-efficacy against SIDS and suffocation correlated with supine positioning, by 5-6 months self-efficacy did not correspond to sleep position in either group."
Characteristics of infant deaths during sleep while under nonparental supervision. Lagon E, Moon RY, Colvin JD. J Pediatr. 2018; 197: 57-62. doi:10.1016/j.jpeds.2018.01.051
"Infants who died of sleep-related causes under nonparental supervision were more likely to have been placed nonsupine. Among nonparental supervisors, relatives and friends were more likely to use unsafe sleep environments, such as locations other than a crib or bassinet and bed sharing. Pediatricians should educate parents that all caregivers must always follow safe sleep practices."
Sudden Infant Death Syndrome: a global public health issue and nursing's response. Pretorius K, Rew L. Compr Child Adolesc Nurs 2018; 4: 1-10. doi:10.1080/24694193.2018.1451569
Commentary. "Motivated by nursing's ethical and moral obligations, the profession is called to take an active role in educating others regarding this phenomenon, to participate in research, and to develop or advocate for policy that aims to reduce the incidence of SIDS on an international scale."
Analysis of Sudden Infant Death Syndrome coverage in Canadian newspapers. Ahmed S, Mitchell I, Wolbring G. J Child Health Care 2018:1367493518763983. doi:10.1177/1367493518763983
"Blame and misdiagnosis were two dominant themes in the coverage of SIDS with many other aspects around SIDS missing; for example, indigenous people, who are at higher risk for SIDS, were rarely mentioned. Our findings suggest problems in the content and frequency of coverage of SIDS that have the potential to shape the public understanding of SIDS."
Dysfunction of NaV1.4, a skeletal muscle voltage-gated sodium channel, in sudden infant death syndrome: a case-control study. Männikkö R, Wong L, Tester DJ, Thor MG, Sud R, Kullmann DM, Sweeney MG, Leu C, Sisodiya SM, FitzPatrick DR, Evans MJ, Jeffrey IJM, Tfelt-Hansen J, Cohen MC, Fleming PJ, Jaye A, Simpson MA, Ackerman MJ, Hanna MG, Behr ER, Matthews E. Lancet 2018; 391 (10129): 1483-1492. doi:10.1016/S0140-6736(18)30021-7
"These findings indicate that dysfunction of muscle sodium channels is a potentially modifiable risk factor in a subset of infant sudden deaths."
Multiple genetic variations in sodium channel subunits in a case of Sudden Infant Death Syndrome. Denti F, Bentzen BH, Wojciak J, Thomsen NM, Scheinman M, Schmitt N. Pacing Clin Electrophysiol 2018; 41 (6): 620-626. doi:10.1111/pace.13328
"Genetic variation of both sodium channel and its modifiers may contribute to sudden unexplained death in childhood."
Causes of death and infant mortality rates among full-term births in the United States between 2010 and 2012: an observational study. Bairoliya N, Fink G. PLoS Med 2018; 15 (3): e1002531. doi:10.1371/journal.pmed.1002531
"Given the high mortality burden due to SIDS and suffocation, policy efforts to promote compliance with recommended sleeping arrangements could be an effective first step in this direction."
Cardiac genetic predisposition in Sudden Infant Death Syndrome. Tester DJ, Wong LCH, Chanana P, Jaye A, Evans JM, FitzPatrick DR, Evans MJ, Fleming P, Jeffrey I, Cohen MC, Tfelt-Hansen J, Simpson MA, Behr ER, Ackerman MJ. J Am Coll Cardiol 2018; 71 (11): 1217-1227. doi:10.1016/j.jacc.2018.01.030
"Less than 15% of more than 400 SIDS cases had a "potentially informative" variant in a GHD-susceptibility gene, predominantly in the 4- to 12-month age group. Only 4.3% of cases possessed immediately clinically actionable variants. Consistent with previous studies, ultra-rare, nonsynonymous variants within the major cardiac channelopathy-associated genes were overrepresented in SIDS cases in infants of European ethnicity."
Sudden Infant Death Syndrome: a review. Goldberg N, Rodriguez-Prado Y, Tillery R, Chua C. Pediatr Ann 2018; 47(3): e118-e123. doi:10.3928/19382359-20180221-03
"This review focuses on SIDS epidemiology, pathogenesis and risk factors, the American Academy of Pediatrics recommendations on safe infant sleeping environment, and the US Centers for Disease Control and Prevention's multistate registry to improve knowledge on SIDS, evaluate trends, and analyze circumstances and events surrounding SIDS cases."
Certified nurse-midwives' knowledge, attitudes, and behaviors about infant safe sleep. Hodges NL, Anderson SE, McKenzie LB, Katz ML. J Midwifery Womens Health 2018; 63 (2): 196-204. doi:10.1111/jmwh.12706
"Many participants (61%) perceived that there were barriers to providing prenatal infant safe sleep education, but nearly all (94%) indicated that they were interested in providing this education to their patients."
Evaluation of a crib distribution and safe sleep educational program to reduce risk of sleep-related infant death. Salm Ward TC, McClellan MM, Miller TJ, Brown S. J Community Health 2018; 43 (5): 848-855. doi:10.1007/s10900-018-0493-1
A prospective, matched pre- and post-test cohort design of a portable crib distribution and safe sleep educational program. "Knowledge of recommendations regarding position, surface, environment, smoking, breastfeeding, and pacifier use increased significantly between pre- and post-test, with most participants maintaining knowledge at follow-up. The proportion of recommended practices also increased significantly. A group-based safe sleep educational program can be effective in reducing risky infant sleep practices."
Sudden infant death and sleep practices in the black community. Stiffler D, Ayres B, Fauvergue C, Cullen D. J Spec Pediatr Nurs 2018; 23 (2):e12213. doi:10.1111/jspn.12213
Qualitative synthesis of literature to understand why Black families don’t follow SIDS advice. "Black mothers tend to believe that SUIDS/SIDS is a random occurrence and is not preventable, so they see a little reason to make their infant sleep in a cold, hard crib, when they could sleep in a warm, comfortable bed with them. Nurses should work with black mothers to understand their cultural beliefs while educating them about safe sleep practices."
Implementing a statewide safe to sleep hospital initiative: lessons learned. Miller TJ, Salm Ward TC, McClellan MM, Dawson L, Ford K, Polatty L, Walcott RL, Corso PS. J Community Health 2018; 43 (4): 768-774. doi:10.1007/s10900-018-0483-3
"Important lessons include: (1) Engagement is vital to success; (2) A comprehensive implementation guide is critical; (3) Piloting the program provides opportunities for refinement; (4) Ongoing support addresses barriers; and (5) Senior leadership facilitates success."
Exploring lactation consultant views on infant safe sleep. Hodges NL, McKenzie LB, Anderson SE, Katz ML. Matern Child Health J 2018; 22 (8): 1111-1117. doi:10.1007/s10995-018-2495-0
Focus groups. "Major themes that emerged included: lactation consultants' beliefs regarding the importance of bedsharing for supporting breastfeeding success; their disagreement with the infant safe sleep recommendations of the American Academy of Pediatrics; their frustration with policies that restrict consultants' ability to discuss bedsharing; and the impact of infant safe sleep policies on their work and the advice they provide. Conclusions for Practice Lactation consultants interact with mothers of newborns at a critical time for infant safe sleep decision-making and may influence a woman's choices related to this topic. Women may not be receiving messages from lactation consultants that are consistent with the infant safe sleep recommendations of the American Academy of Pediatrics."
National and state trends in sudden unexpected infant death: 1990-2015. Erck Lambert AB, Parks SE, Shapiro-Mendoza CK. Pediatrics 2018; 141 (3). pii:e20173519. doi:10.1542/peds.2017-3519
"Reductions in SUID rates since 1999 have been minimal, and wide variations in state-specific rates remain. States with significant declines in SUID rates might have SUID risk-reduction programs that could serve as models for other states."
Barriers to and interventions that increase nurses' and parents' compliance with safe sleep recommendations for preterm infants. Naugler MR, DiCarlo K. Nurs Womens Health 2018; 22 (1): 24-39. doi:10.1016/j.nwh.2017.12.009
Integrative literature review. "We conclude that hospitals should have current, evidence-based safe sleep policies with clear transition guidelines for premature infants and that consistent and comprehensive nursing and parental education related to safe sleep should include current American Academy of Pediatrics recommendations and should address potential barriers to compliance."
Neuropathology of sudden infant death syndrome: review of the literature and proposal of a protocol for neuropathological examination [French]. Delteil C, Meyronet D, Maues de Paula A, Jouvet A, Piercecchi-Marti MD. Ann Pathol 2018; 38 (2): 103-109. doi:10.1016/j.annpat.2018.01.001
"This article aims to define a detailed sampling protocol based on foreign consensus and current data of science in order to assist pathologists and to promote a homogeneous data bank in France."
Sudden unexpected infant death: time for integrative national registries. Levieux K, Patural H, Harrewijn I, Briand Huchet E, Kugener B, Pidoux O, de Visme S, Adjaoud C, Gras Le Guen C, Hanf M; ANCReMIN. Arch Pediatr 2018; 25 (2): 75-76. doi:10.1016/j.arcped.2017.12.008
"The French referral centers are firmly convinced that this integrative approach concerning SUID should be generalized and applied to other countries. It has the potential to provide an effective response to this major public health issue by helping better appreciate the contributions to SUID of specific risk factors, precisely monitor SIDS and SUID trends, improve the management of SUID cases and their families, and develop fundamental research studies to effectively reduce infant deaths."
Medullary astrogliosis in Sudden Infant Death Syndrome varies with sleeping environment: evidence for different mechanisms of death in alone versus co-sleepers? Spinelli J, Byard RW, Van Den Heuvel C, Collins-Praino LE. J Child Neurol 2018; 33 (4): 269-274. doi:10.1177/0883073817750498
"The amount of glial fibrillary acidic protein (GFAP) staining in alone sleepers was significantly higher than shared sleepers in 3 specific areas of the medulla, the inferior vestibular nucleus, the medial vestibular nucleus and the cochlear nucleus."
The Pēpi-Pod study: overnight video, oximetry and thermal environment while using an in-bed sleep device for sudden unexpected death in infancy prevention. Tipene-Leach D, Baddock SA, Williams SM, Tangiora A, Jones R, McElnay C, Taylor BJ. J Paediatr Child Health 2018; 54 (6): 638-646. doi:10.1111/jpc.13845
"Overall, we found that most differences in infant risk behaviours in a Pēpi-Pod compared to a bassinet were small, with confidence intervals excluding meaningful differences. We noted poorer maternal sleep quality at 1 month. Higher infant heart rates in the Pēpi-Pod group may be related to higher room temperatures. The Pēpi-Pod appears physiologically safe but is associated with lower reported maternal sleep quality."
Bed-sharing in the first 8 weeks of life: an Australian study. Cunningham HM, Vally H, Bugeja L. Matern Child Health J 2018; 22 (4): 556-564. doi:10.1007/s10995-017-2424-7
"Noted gaps in how families are implementing current recommendations about reducing the risk of SUDI were identified for sleep position, sleep location and the sleep environment. Further consideration needs to be given to addressing these gaps and applying these findings of current bed-sharing practices to the development of infant safe sleeping policy and programs."
Cardiovascular autonomic dysfunction in Sudden Infant Death Syndrome. Horne RSC. Clin Auton Res 2018; 28 (6): 535-543. doi:10.1007/s10286-017-0490-y
"This review discusses the association between the three components of the triple risk hypothesis and major risk factors for SIDS, such as prone sleeping, maternal smoking, together with three "protective" factors, and cardiovascular control during sleep in infants, and discusses their potential involvement in SIDS."
Sudden Infant Death Syndrome, attention-deficit/hyperactivity disorder and vaccines: longitudinal population analyses. Yang YT, Shaw J. Vaccine 2018; 36 (5): 595-598. doi:10.1016/j.vaccine.2017.12.065
"We found that state-level childhood vaccine uptake for age appropriate vaccines was neither associated with the decline in the incidence of SIDS nor rise in the prevalence of ADHD. Our findings provide current and evidence-based information to assist providers counseling vaccine-hesitant parents."
Is it time for a Sudden Infant Death Syndrome (SIDS) awareness campaign? Community stakeholders' perceptions of SIDS. Gollenberg A, Fendley K. Child Care Pract 2018; 24 (1): 53-64. doi:10.1080/13575279.2016.1259155
USA: Virgina. "Community leaders perceive that high-risk community members are not fully aware of risk factors that can lead to SIDS. Maternal/child health stakeholders in these Virginia locales suggested more community-based education as a potential solution to SIDS."
Why is a prone sleeping position dangerous for certain infants? Byard RW, Bright F, Vink R. Forensic Sci Med Pathol 2018; 14 (1): 114-116. doi:10.1007/s12024-017-9941-y
"Recent studies have, however, shown a significant reduction in substance P in the inferior portion of the olivo-cerebellar complex in SIDS infants which is crucial for the integration of motor and sensory information for the control of head and neck movement. This deficit may explain why some infants are not able to move their faces away from potentially dangerous sleeping environments."
Cot death: history of an iatrogenic disaster. Obladen M. Neonatology 2018; 113 (2): 162-169. doi:10.1159/000481880
"Cot death disappeared almost entirely wherever prone sleeping was avoided. This strongly supports the assumption that prone sleeping has the greatest influence on the disorder, and that the epidemic resulted from wrong advice."
Risky behaviors of mothers with infants on Sudden Infant Death Syndrome in Turkey. Erdoğan Ç, Turan T. J Pediatr Nurs 2018; 38: e2-e6. doi:10.1016/j.pedn.2017.11.017
"A total of 77.9% of the mothers put their babies in bed in a non-supine position; 65.8% used a pillow when they put their babies in bed, 52.9% used a soft mattress, and 28.5% shared their beds with their babies. Prone sleeping was more likely to occur when smoke was present in the home or a pillow was used."
A statewide hospital-based safe infant sleep initiative: measurement of parental knowledge and behavior. Walcott RL, Salm Ward TC, Ingels JB, Llewellyn NA, Miller TJ, Corso PS. J Community Health 2018; 43 (3): 534-542. doi:10.1007/s10900-017-0449-x
"Implementation of a statewide hospital initiative was associated with high levels of parental knowledge and behavior and may have been successful in reducing the practice of bed sharing among Medicaid parents."
The prone sleeping position and SIDS. Historical aspects and possible pathomechanisms. Sperhake J, Jorch G, Bajanowski T. Int J Legal Med 2018; 132 (1): 181-185. doi:10.1007/s00414-017-1749-5
"Such mechanisms could be occlusion of airways (in particularly associated with face-down position), elevated diaphragm, positional cerebral hypoxia caused by constriction of arteries, rebreathing CO2, and overheating.Irrespective of the specific pathomechanism leading to death in individual cases, it has been established that the prone position is the most important risk factor for SIDS and therefore should be incorporated in the definition of the term SIDS."
Qualitative analysis of infant safe sleep public campaign messaging. Peacock NR, Altfeld S, Rosenthal AL, Garland CE, Massino JM, Smith SL, Rowe HL, Wagener SE. Health Promot Pract 2018; 19 (2): 203-212. doi:10.1177/1524839917690339
"Campaigns frequently targeted priority populations such as African Americans. Fear appeals were used in three quarters of the campaigns, and 60% of the fear-based campaigns used guilt/blame messaging. We did not find published evaluation data for any of the campaigns. More attention is needed in public education campaigns to the full range of AAP recommendations, and evaluations are needed to determine the impact of these interventions on knowledge, behavior, and health outcomes."
Trends and factors associated with breastfeeding and infant sleep oractices in Georgia. Salm Ward TC, Kanu FA, Anderson AK. J Community Health 2018; 43 (3): 496-507. doi:10.1007/s10900-017-0442-4
"Our results suggest the need for targeted education and support for breastfeeding and safe sleep practices."
Infant safe sleep: a survey of the knowledge, attitudes, and behaviors of obstetric physicians. Hodges NL, Anderson SE, McKenzie LB, Katz ML. J Community Health 2018; 43 (3): 488-495. doi:10.1007/s10900-017-0441-5
"Obstetric physicians can influence the infant safe sleep decisions that women make. Improving obstetricians' knowledge and attitudes about infant safe sleep and supporting physicians who wish to provide education on this topic may help to ensure that women are receiving frequent and consistent infant safe sleep messaging throughout the prenatal period."
Prone sleeping position in infancy: implications for cardiovascular and cerebrovascular function. Shepherd KL, Yiallourou SR, Horne RSC, Wong FY. Sleep Med Rev 2018; 39: 174-186. doi:10.1016/j.smrv.2017.10.001
"This review examines the cardiovascular and cerebrovascular effects of prone sleeping in infants born at term, those born preterm after term equivalent age and whilst hospitalized."
Evaluation of a sudden unexpected death in infancy intervention programme aimed at improving parental awareness of risk factors and protective infant care practices. McIntosh C, Trenholme A, Stewart J, Vogel A. J Paediatr Child Health 2018; 54 (4): 377-382. doi:10.1111/jpc.13772
Pepi-Pod vs Usual Care trial. "Bed-sharing and knowledge improvement were similar irrespective of group. It is likely that the impact of the intervention was reduced because the control group received better support than 'usual care' and all participants had a baby bed. New Zealand SUDI rates have declined since sleep space programmes have been available. Sleep space programmes should be prioritised for those with modifiable SUDI risk."
Babies in boxes and the missing links on safe sleep: human evolution and cultural revolution. Bartick M, Tomori C, Ball HL. Matern Child Nutr 2018; 14 (2): e12544. doi:10.1111/mcn.12544
"Distribution of baby boxes may divert resources and attention away from addressing these other risk factors and lead to a false sense of security wherein we overlook that sudden unexplained infant deaths also occur in solitary sleep environments."
Stock photographs do not comply with infant safe sleep guidelines. Goodstein MH, Lagon E, Bell T, Joyner BL, Moon RY. Clin Pediatr (Phila) 2018; 57 (4): 403-409. doi:10.1177/0009922817728698
"Images depicting sleeping infants on stock photography sites do not routinely adhere to AAP recommendations. Media messages inconsistent with health care messages create confusion and misinformation about infant sleep safety and may lead inadvertently to unsafe practices."
Mothers' knowledge and attitudes to Sudden Infant Death Syndrome risk reduction messages: results from a UK survey. Pease AS, Blair PS, Ingram J, Fleming PJ. Arch Dis Child 2018; 103 (1): 33-38. doi:10.1136/archdischild-2017-312927
"Mothers in the higher risk group were disadvantaged when it came to some aspects of knowledge of SIDS risk reduction and attitudes to safer sleep. The initial 'Back-to Sleep' message that dramatically reduced these deaths a generation ago needs more effective promotion for today's generation of mothers."
What do pediatricians tell parents about bed-sharing? Schaeffer P, Asnes AG. Matern Child Health J 2018; 22(1): 51-58. doi:10.1007/s10995-017-2353-5
Qualitative study of 24 primary care paediatricians in the USA. "Some strongly and routinely advise against bed-sharing and identify bed-sharing as a clear risk to infants. Others believe bed-sharing to be both safe and useful. A third group allow the content of anticipatory guidance to be driven by parental concerns."