Objective To assess the relationship between diurnal temperature range （DTR） and sudden infant death （SID） between 2001 and 2004 in Shanghai,China.Methods We conducted a time‐stratified case‐crossover analysis t...Objective To assess the relationship between diurnal temperature range （DTR） and sudden infant death （SID） between 2001 and 2004 in Shanghai,China.Methods We conducted a time‐stratified case‐crossover analysis to estimate the percent increase of SID associated with changes in DTR after adjustment for daily weather conditions （temperature and relative humidity） and outdoor air pollution.Results DTR was significantly associated with daily SID.An increase of 1 °C in the current‐day （L0） and in the 2‐day moving average （L01） DTR corresponds to a 1.56% （95% CI：0.97%,2.15%） and a 1.89% （95% CI：1.17%,2.60%） increase in SID,respectively.Conclusion An increased DTR was associated with an increased risk of SID in Shanghai.More studies are needed to understand the effect of DTR on infant deaths.展开更多
BACKGROUND The term sudden unexpected infant death(SUID)is not always properly invoked.It refers to a broad range of conditions that sometimes defy classification.There is not only a strong emotional impact on the fam...BACKGROUND The term sudden unexpected infant death(SUID)is not always properly invoked.It refers to a broad range of conditions that sometimes defy classification.There is not only a strong emotional impact on the family,but such cases are also quite complex.Underlying causes may be multiple,not always readily apparent,and have potential repercussions,especially in terms of forensics.CASE SUMMARY A 5-month-old male baby was pronounced dead following acute lung failure and cardiopulmonary arrest.The parents had immediately rushed their child to the hospital,stating the baby was found prone and not breathing.Total-body postmortem computed tomography(PMCT)was performed,revealing a hypodense material of indeterminate nature within the main airways and areas of ground-glass parenchymal change.At autopsy,the respiratory tract mucosa appeared edematous and was coated with a whitish stringy material.There was widespread airspace reduction due to parenchymal collapse.Alveolar sacs and bronchial openings contained abundant amorphous material admixed with white blood cells.Immunohistochemical studies were performed,targeting CD15,CD68,and alpha-lactalbumin.Ultimately,the focus was on alpha-lactalbumin(milk protein),which showed marked immunopositivity within alveolar spaces.Cytoplasmic staining of macrophages was also particularly prominent.CONCLUSION Postmortem investigations are thus essential to identify causes of death and surrounding circumstances.PMCT is a useful tool in this setting,given the frequent dearth of autopsy findings and ambiguity as to cause of death in SUID cases.These findings,later confirmed by immunohistochemical investigations,were indicative of active pneumonia due to aspirated milk.The present account illustrates the importance a broad diagnostic approach to SUID in cases of forensic concern.PMCT is a very valuable aid in cases of forensic interest,as it can provide useful information in all those situations in which the cause of death is uncertain or there are no suggestive dynamics or lesions.展开更多
We utilized data from the National Maternal and Infant Health Survey (NMHIS) to analyze the risk of SIDS and other infant deaths among women who smoke during pregnancy adjusting for potentially modifiable risk factors...We utilized data from the National Maternal and Infant Health Survey (NMHIS) to analyze the risk of SIDS and other infant deaths among women who smoke during pregnancy adjusting for potentially modifiable risk factors such as secondhand smoke exposure and breastfeeding. The following variables were assessed with respect to risk for SIDS and other infant deaths: smoking exposure, level of education, infant and maternal age, infant and maternal birthweight, maternal BMI, gender, secondhand smoke exposure, breast feeding, prenatal vitamins, WIC, multiple gestation, sleep apnea monitor prescription, sleep apnea incidents and maternal alcohol use. Univariate analysis and multivariate logistic regression were performed to identify variables significantly associated with the odds of mortality from SIDS. Analysis utilized weighted estimates using SUDAAN 9.0.0 to adjust for design effects. A p-value <0.01 was considered statistically significant. Women who smoked during pregnancy were 1.83 times more likely to give birth to an infant that died from SIDS versus some other cause of death, OR (95%) = 1.83(1.33, 2.51). Other Race infants and Black infants were more likely to suffer SIDS mortality than White infants, but the result was not significant in the final model. Other modifiable risk factors, such as secondhand smoke exposure and breast feeding, were not significant predictors of SIDS mortality. Independent of sociodemographic variables and other potential risk factors for SIDS death, maternal smoking was associated with an increased risk of SIDS death versus other death. This study highlights the importance of screening all pregnant women for tobacco use and emphasizes the importance of smoking cessation to decrease the risk of infant death from SIDS.展开更多
Here we describe the case of a 4-mo-old female who died suddenly without any apparent cause that was initially mistaken as a case of sudden infant death syndrome. Histologic observation of brain sections revealed blue...Here we describe the case of a 4-mo-old female who died suddenly without any apparent cause that was initially mistaken as a case of sudden infant death syndrome. Histologic observation of brain sections revealed blue-black bodies in erythrocytes of the blood vessels, suggestive of specific stages of the hematic schizogonic cycle. Further examinations revealed hemozoin and hemosiderin deposits in the parenchyma of all organs, leading to the diagnosis of malaria by Plasmodium falciparum(P. falciparum). The death occurred in Italy, the native country of the infant, two weeks after a Christmas holiday spent in Pakistan, the parents' birthplace, which has a high malarial endemicity. As this case demonstrates, the diagnosis of malaria should always be considered as a differential diagnosis in subjects, including infants, that die unexpectedly after returning from P. falciparum endemic areas.展开更多
AIM:To identify a hypothesis on:Supine sleep,sudden infant death syndrome(SIDS) reduction and association with increasing autism incidence.METHODS:Literature was searched for autism spectrum disorder incidence time tr...AIM:To identify a hypothesis on:Supine sleep,sudden infant death syndrome(SIDS) reduction and association with increasing autism incidence.METHODS:Literature was searched for autism spectrum disorder incidence time trends,with correlation of change-points matching supine sleep campaigns.A mechanistic model expanding the hypothesis was constructed based on further review of epidemiological and other literature on autism.RESULTS:In five countries(Denmark,United Kingdom,Australia,Israel,United States) with published time trends of autism,change-points coinciding with supine sleep campaigns were identified.The model proposes that supine sleep does not directly cause autism,but increases the likelihood of expression of a subset of autistic criteria in individuals with genetic susceptibility,thereby specifically increasing the incidence of autism without intellectual disability.CONCLUSION:Supine sleep is likely a physiological stressor,that does reduce SIDS,but at the cost of impact on emotional and social development in the population,a portion of which will be susceptible to,and consequently express autism.A re-evaluation of all benefits and harms of supine sleep is warranted.If the SIDS mechanism proposed and autism model presented can be verified,the research agenda may be better directed,in order to further decrease SIDS,and reduce autism incidence.展开更多
Background:The objective of our study is to measure the incidence of sudden infant death syndrome(SIDS),estimate the birth to death interval,and identify associated maternal and infant risk factors.Methods:We carried ...Background:The objective of our study is to measure the incidence of sudden infant death syndrome(SIDS),estimate the birth to death interval,and identify associated maternal and infant risk factors.Methods:We carried out a population-based cohort study on 37418280 births using data from the Centers for Disease Control and Prevention's"Linked Birth-Infant Death"and"Fetal Death"data files from 1995 to 2004.Descriptive statistics and cox-proportional hazard models were used to estimate the adjusted effect of maternal and newborn characteristics on the risk of SIDS.Results:There were 24101 cases of SIDS identified for an overall 10-year incidence of 6.4 cases per 10000 births.Over the study period,the incidence decreased from 8.1 to 5.6 per 10000 and appeared to be most common among infants aged 2-4 months.Risk factors inchuded maternal age<20 years,black,non-Hispanic race,smoking,increasing parity,inadequate prenatal care,prematurity and growth restriction.Conclusions:While the incidence of SIDS in the US has declined,it currently remains the leading cause of post-neonatal mortality,highlighting an important public health priority.Educational campaigns should be targeted towards mothers at increased risk in order to raise their awareness of modifiable risk factors for SIDS such as maternal smoking and inadequate prenatal care.展开更多
Background Comprehensive quantitative evidence on the risk and protective factors for sudden infant death syndrome(SIDS)effects is lacking.We investigated the risk and protective factors related to SIDS.Methods We con...Background Comprehensive quantitative evidence on the risk and protective factors for sudden infant death syndrome(SIDS)effects is lacking.We investigated the risk and protective factors related to SIDS.Methods We conducted an umbrella review of meta-analyses of observational and interventional studies assessing SIDS-related factors.PubMed/MEDLINE,Embase,EBSCO,and Google Scholar were searched from inception until January 18,2023.Data extraction,quality assessment,and certainty of evidence were assessed by using A Measurement Tool Assessment Systematic Reviews 2 following PRISMA guidelines.According to observational evidence,credibility was graded and classified by class and quality of evidence(CE;convincing,highly suggestive,suggestive,weak,or not significant).Our study protocol was registered with PROSPERO(CRD42023458696).The risk and protective factors related to SIDS are presented as equivalent odds ratios(eORs).Results We identified eight original meta-analyses,including 152 original articles,covering 12 unique risk and protective factors for SIDS across 21 countries/regions and five continents.Several risk factors,including prenatal drug exposure[eOR=7.84(95%CI=4.81–12.79),CE=highly suggestive],prenatal opioid exposure[9.55(95%CI=4.87–18.72),CE=suggestive],prenatal methadone exposure[9.52(95%CI=3.34–27.10),CE=weak],prenatal cocaine exposure[4.38(95%CI=1.95–9.86),CE=weak],prenatal maternal smoking[2.25(95%CI=1.95–2.60),CE=highly suggestive],postnatal maternal smoking[1.97(95%CI=1.75–2.22),CE=weak],bed sharing[2.89(95%CI=1.81–4.60),CE=weak],and infants found with heads covered by bedclothes after last sleep[11.01(95%CI=5.40–22.45),CE=suggestive],were identified.On the other hand,three protective factors,namely,breastfeeding[0.57(95%CI=0.39–0.83),CE=non-significant],supine sleeping position[0.48(95%CI=0.37–0.63),CE=suggestive],and pacifier use[0.44(95%CI=0.30–0.65),CE=weak],were also identified.Conclusions Based on the evidence,we propose several risk and protective factors for SIDS.This study suggests the need for further studies on SIDS-related factors supported by weak credibility,no association,or a lack of adequate research.展开更多
The serotonin transporter(5‑HTT)gene has been considered one of the risk factors for sudden infant death syndrome(SIDS),but the association remains unconfirmed.This meta‑analysis was performed to quantitatively summar...The serotonin transporter(5‑HTT)gene has been considered one of the risk factors for sudden infant death syndrome(SIDS),but the association remains unconfirmed.This meta‑analysis was performed to quantitatively summarize the evidence for such a relationship.PubMed,EMBASE,and China National Knowledge Infrastructure databases were searched for eligible studies within a range of published years from 1990 to December 2015.The odds ratios(ORs)with 95%confidence intervals(CIs)were used to assess the different associations.A total of 8 studies with 624 cases and 796 controls were included for 5‑HTT promoter polymorphism,5 studies with 418 cases and 542 controls for intron 2,and 3 studies with 253 cases and 334 controls for haplotype.The pooled examinations showed an overall increased SIDS risk for the 5‑HTT promoter polymorphism(OR=1.65,95%CI=1.03–2.63,P=0.035 for LL vs.LS and SS;OR=1.46,95%CI=1.04–2.04,P=0.028 for L vs.S),but no association(OR=1.00,95%CI=0.75–1.33,P=0.994 for 10+9 carriers vs.12/12;OR=0.97,95%CI=0.79–1.19,P=0.753 for 10+9 vs.12)for intron 2 polymorphism,and an unreliable association(OR=0.52,95%CI=0.31–0.87,P=0.013)for S‑9 and S‑10 haplotypes.This meta‑analysis suggests that the L allele or LL homozygote of 5‑HTT promoter polymorphism has an increased risk for SIDS,while intron 2 polymorphism has no association with SIDS.展开更多
Sudden Infant Death Syndrome （SIDS） is an unexpected death of infants under one year old. SIDS is the most common cause of death for infants after the first month of birth, commonly between two and four months. MEMS...Sudden Infant Death Syndrome （SIDS） is an unexpected death of infants under one year old. SIDS is the most common cause of death for infants after the first month of birth, commonly between two and four months. MEMS （Micro-Electro-Mechanical Systems） technology can be very useful to help us to avoid this horrible tragedy. In the present work, using a MEMS technology, an intelligent pacifier is designed to alarm any unusual changes in breathing during sleeping. A PZT （Piezoelectric） sensor is utilized to detect the force generated by breathing and convert it to a measurable voltage and alarm the risky breathing during infant＇s sleeping. This voltage can subsequently drive some simple alarm and make parents aware of hazard.展开更多
Objective To find the pathogenesis of sudden infant death syndrome (SIDS) from changes of pulmonary surfactant. Methods By means of thin layer chromatography technique, surfactant in whole lung specimens of 10 inf...Objective To find the pathogenesis of sudden infant death syndrome (SIDS) from changes of pulmonary surfactant. Methods By means of thin layer chromatography technique, surfactant in whole lung specimens of 10 infants with SIDS and 10 control infants without SIDS (dead of nonrespiratory diseases) were examined qualitatively and quantitatively. Results Eleven components in pulmonary surfactant were examined qualitatively, including lysophosphatidylcholine, sphingomyelin, phosphatidylcholine, phosphatidylserine, phosphatidylinositol, phosphatidylethanolamine, phosphatidylglycerol, diphosphatidylglycerol, phosphatidic acid, cholesterol and neutral lipids. Quantitative examination showed that the amount of surfactant of whole lung specimens in sudden death group [(8.9±1.0) mg/g wet lung weight] was significantly less than that in control group [(12.6±1.4) mg/g wet lung weight, P<0.01]. Qualitative variance showed that the percentages of phosphatidylcholine (49.4%±2.0%) and phosphatidylglycerol (2.6%±0.7%) decreased markedly in sudden death group compared with those in control group (61.5%±3.0% and 4.3%±1.5%, P<0.01). Conclusion Before death there is serious defect on metabolism of pulmonary surfactant in sudden death infants, with the amount decreasing and the ratio of its components being disturbed, which is one of the important pathogenies of SIDS.展开更多
[提示]母乳喂养,英语叫breast-fed。母乳喂养婴儿,好处可谓多矣!首先在诞生一年之內,婴儿的死亡率就比非母乳喂养者降低了20％。别的好处也很多,比如:Other studies have shown breast-fed babies are less likely to be overweight,hav...[提示]母乳喂养,英语叫breast-fed。母乳喂养婴儿,好处可谓多矣!首先在诞生一年之內,婴儿的死亡率就比非母乳喂养者降低了20％。别的好处也很多,比如:Other studies have shown breast-fed babies are less likely to be overweight,have fewer behavioral problems and may show differences in intelligence.They also may grow up to have lower blood pressure(血压).调查还证明,当今美国母乳喂养的婴儿占婴儿总数之70％!笔者甚至怀疑,我国是否达到了这个标准,尤其是都市年轻母亲。展开更多
The infant mortality rate in China declined from 50.2‰ to 13.8‰ between 1991 and 2009.1 Although China has made good progress,there were still about 190 thousand infants who died in 2009.Reliable birth and death reg...The infant mortality rate in China declined from 50.2‰ to 13.8‰ between 1991 and 2009.1 Although China has made good progress,there were still about 190 thousand infants who died in 2009.Reliable birth and death registration and the causes of death in populations are essential for public health planning.The National Maternal and Child Mortality Surveillance System （MCMS） is the major system to register maternal and infant deaths.It samples 126 districts and 210 counties,totally 336 sites,covering 12% of counties and 9% of the population.Causes of deaths are determined by the attending clinician.For those who die out hospital or clinic,a community health provider will be asked to visit that family and make a decision as to the cause of death.展开更多
Introduction: Sub-optimal infant and early childhood feeding practices in India contribute to the high burden of child under-nutrition and infant death. Objective: To study the effect of breast-feeding duration on the...Introduction: Sub-optimal infant and early childhood feeding practices in India contribute to the high burden of child under-nutrition and infant death. Objective: To study the effect of breast-feeding duration on the survival of infants along with other demographic, socioeconomic and service related factors and to compare the decadal changes in the association. Methods: A total of 36,754 and 26,782 births less than 3 years of age from two rounds of the National Family Health Survey (NFHS) carried out in India during 1992-1993 (NFHS-1), and 2005-2006 (NFHS-3) respectively comprised the sample. Infant mortality was examined against a set of variables and breastfeeding as a time dependent covariate using multivariate extended Cox regression model. Results: Hazard of infant death observed in NFHS-3 (2005-2006) was 18 percent less [HR = 0.82;95% CI = 0.759 - 0.879] as compared to that observed in NFHS-1 (1992-1993). After adjustment of other factors, the risk of infant death was 97% less amongst children who were breastfed [HR = 0.03;95% CI = 0.029 - 0.033] as compared to those who were not breastfed. In contrast to rural area, babies belonging to urban area had an 18 percent less hazard of death during the infancy period [HR = 0.82]. Hazard of infant death was less among births to mothers with higher maternal education levels [HR = 0.93] and in those who were in gainful occupation [HR = 0.91]. The risk of infant death was higher in babies perceived to be small at birth [HR = 1.40] and belonging to states with medium post neonatal mortality rate (PNMR) [HR = 1.23;95% CI = 1.112 - 1.371] and high PNMR [HR = 1.46;95% CI = 1.327 - 1.609] in contrast to those born to women belonging to states with low post neonatal mortality. Conclusion: Promotion and implementation of evidenced based strategies are needed in India to combat the high rates of child under-nutrition and infant and child mortality.展开更多
近20多年来,婴儿猝死综合征(sudden infant death syndrome,SIDS)一直是西方发达国家医学界尤其是法医学和儿科学领域研究的热点。目前,随着对SIDS广泛而深入的研究,对其病因、发病特点、危险因素以及致病机制等都有了更明确的认识。虽...近20多年来,婴儿猝死综合征(sudden infant death syndrome,SIDS)一直是西方发达国家医学界尤其是法医学和儿科学领域研究的热点。目前,随着对SIDS广泛而深入的研究,对其病因、发病特点、危险因素以及致病机制等都有了更明确的认识。虽说近年来SIDS的发病率已有明显下降,在欧美洲、澳洲等发达国家,SIDS仍然是导致1个月到1岁婴儿死亡的首要原因。在亚洲国家和地区,尤其是发展中国家SIDS的报道很少见。本文通过总结文献并结合美国马里兰州近20年(1990—2006)来对SIDS的调查研究资料,介绍SIDS的发展历史、研究现状和新的发展趋势,并对SIDS法医学鉴定程序及鉴定要素进行讨论。展开更多
基金supported by the National Basic Research Program (973 program) of China (2011CB503802)the National Natural Science Foundation of China (81001228)+2 种基金the National High Technology Research and Development Program of China (863 Program) (2007AA02Z442)the Shanghai Pu Jiang Program (09PJ1401700)the Program for New Century Excellent Talents in University (NCET-09-0314)
文摘Objective To assess the relationship between diurnal temperature range （DTR） and sudden infant death （SID） between 2001 and 2004 in Shanghai,China.Methods We conducted a time‐stratified case‐crossover analysis to estimate the percent increase of SID associated with changes in DTR after adjustment for daily weather conditions （temperature and relative humidity） and outdoor air pollution.Results DTR was significantly associated with daily SID.An increase of 1 °C in the current‐day （L0） and in the 2‐day moving average （L01） DTR corresponds to a 1.56% （95% CI：0.97%,2.15%） and a 1.89% （95% CI：1.17%,2.60%） increase in SID,respectively.Conclusion An increased DTR was associated with an increased risk of SID in Shanghai.More studies are needed to understand the effect of DTR on infant deaths.
文摘BACKGROUND The term sudden unexpected infant death(SUID)is not always properly invoked.It refers to a broad range of conditions that sometimes defy classification.There is not only a strong emotional impact on the family,but such cases are also quite complex.Underlying causes may be multiple,not always readily apparent,and have potential repercussions,especially in terms of forensics.CASE SUMMARY A 5-month-old male baby was pronounced dead following acute lung failure and cardiopulmonary arrest.The parents had immediately rushed their child to the hospital,stating the baby was found prone and not breathing.Total-body postmortem computed tomography(PMCT)was performed,revealing a hypodense material of indeterminate nature within the main airways and areas of ground-glass parenchymal change.At autopsy,the respiratory tract mucosa appeared edematous and was coated with a whitish stringy material.There was widespread airspace reduction due to parenchymal collapse.Alveolar sacs and bronchial openings contained abundant amorphous material admixed with white blood cells.Immunohistochemical studies were performed,targeting CD15,CD68,and alpha-lactalbumin.Ultimately,the focus was on alpha-lactalbumin(milk protein),which showed marked immunopositivity within alveolar spaces.Cytoplasmic staining of macrophages was also particularly prominent.CONCLUSION Postmortem investigations are thus essential to identify causes of death and surrounding circumstances.PMCT is a useful tool in this setting,given the frequent dearth of autopsy findings and ambiguity as to cause of death in SUID cases.These findings,later confirmed by immunohistochemical investigations,were indicative of active pneumonia due to aspirated milk.The present account illustrates the importance a broad diagnostic approach to SUID in cases of forensic concern.PMCT is a very valuable aid in cases of forensic interest,as it can provide useful information in all those situations in which the cause of death is uncertain or there are no suggestive dynamics or lesions.
文摘We utilized data from the National Maternal and Infant Health Survey (NMHIS) to analyze the risk of SIDS and other infant deaths among women who smoke during pregnancy adjusting for potentially modifiable risk factors such as secondhand smoke exposure and breastfeeding. The following variables were assessed with respect to risk for SIDS and other infant deaths: smoking exposure, level of education, infant and maternal age, infant and maternal birthweight, maternal BMI, gender, secondhand smoke exposure, breast feeding, prenatal vitamins, WIC, multiple gestation, sleep apnea monitor prescription, sleep apnea incidents and maternal alcohol use. Univariate analysis and multivariate logistic regression were performed to identify variables significantly associated with the odds of mortality from SIDS. Analysis utilized weighted estimates using SUDAAN 9.0.0 to adjust for design effects. A p-value <0.01 was considered statistically significant. Women who smoked during pregnancy were 1.83 times more likely to give birth to an infant that died from SIDS versus some other cause of death, OR (95%) = 1.83(1.33, 2.51). Other Race infants and Black infants were more likely to suffer SIDS mortality than White infants, but the result was not significant in the final model. Other modifiable risk factors, such as secondhand smoke exposure and breast feeding, were not significant predictors of SIDS mortality. Independent of sociodemographic variables and other potential risk factors for SIDS death, maternal smoking was associated with an increased risk of SIDS death versus other death. This study highlights the importance of screening all pregnant women for tobacco use and emphasizes the importance of smoking cessation to decrease the risk of infant death from SIDS.
文摘Here we describe the case of a 4-mo-old female who died suddenly without any apparent cause that was initially mistaken as a case of sudden infant death syndrome. Histologic observation of brain sections revealed blue-black bodies in erythrocytes of the blood vessels, suggestive of specific stages of the hematic schizogonic cycle. Further examinations revealed hemozoin and hemosiderin deposits in the parenchyma of all organs, leading to the diagnosis of malaria by Plasmodium falciparum(P. falciparum). The death occurred in Italy, the native country of the infant, two weeks after a Christmas holiday spent in Pakistan, the parents' birthplace, which has a high malarial endemicity. As this case demonstrates, the diagnosis of malaria should always be considered as a differential diagnosis in subjects, including infants, that die unexpectedly after returning from P. falciparum endemic areas.
文摘AIM:To identify a hypothesis on:Supine sleep,sudden infant death syndrome(SIDS) reduction and association with increasing autism incidence.METHODS:Literature was searched for autism spectrum disorder incidence time trends,with correlation of change-points matching supine sleep campaigns.A mechanistic model expanding the hypothesis was constructed based on further review of epidemiological and other literature on autism.RESULTS:In five countries(Denmark,United Kingdom,Australia,Israel,United States) with published time trends of autism,change-points coinciding with supine sleep campaigns were identified.The model proposes that supine sleep does not directly cause autism,but increases the likelihood of expression of a subset of autistic criteria in individuals with genetic susceptibility,thereby specifically increasing the incidence of autism without intellectual disability.CONCLUSION:Supine sleep is likely a physiological stressor,that does reduce SIDS,but at the cost of impact on emotional and social development in the population,a portion of which will be susceptible to,and consequently express autism.A re-evaluation of all benefits and harms of supine sleep is warranted.If the SIDS mechanism proposed and autism model presented can be verified,the research agenda may be better directed,in order to further decrease SIDS,and reduce autism incidence.
文摘Background:The objective of our study is to measure the incidence of sudden infant death syndrome(SIDS),estimate the birth to death interval,and identify associated maternal and infant risk factors.Methods:We carried out a population-based cohort study on 37418280 births using data from the Centers for Disease Control and Prevention's"Linked Birth-Infant Death"and"Fetal Death"data files from 1995 to 2004.Descriptive statistics and cox-proportional hazard models were used to estimate the adjusted effect of maternal and newborn characteristics on the risk of SIDS.Results:There were 24101 cases of SIDS identified for an overall 10-year incidence of 6.4 cases per 10000 births.Over the study period,the incidence decreased from 8.1 to 5.6 per 10000 and appeared to be most common among infants aged 2-4 months.Risk factors inchuded maternal age<20 years,black,non-Hispanic race,smoking,increasing parity,inadequate prenatal care,prematurity and growth restriction.Conclusions:While the incidence of SIDS in the US has declined,it currently remains the leading cause of post-neonatal mortality,highlighting an important public health priority.Educational campaigns should be targeted towards mothers at increased risk in order to raise their awareness of modifiable risk factors for SIDS such as maternal smoking and inadequate prenatal care.
基金supported by the National Research Foundation of Korea(NRF)grant funded by the Korea government(MSIT,RS-2023-00248157)。
文摘Background Comprehensive quantitative evidence on the risk and protective factors for sudden infant death syndrome(SIDS)effects is lacking.We investigated the risk and protective factors related to SIDS.Methods We conducted an umbrella review of meta-analyses of observational and interventional studies assessing SIDS-related factors.PubMed/MEDLINE,Embase,EBSCO,and Google Scholar were searched from inception until January 18,2023.Data extraction,quality assessment,and certainty of evidence were assessed by using A Measurement Tool Assessment Systematic Reviews 2 following PRISMA guidelines.According to observational evidence,credibility was graded and classified by class and quality of evidence(CE;convincing,highly suggestive,suggestive,weak,or not significant).Our study protocol was registered with PROSPERO(CRD42023458696).The risk and protective factors related to SIDS are presented as equivalent odds ratios(eORs).Results We identified eight original meta-analyses,including 152 original articles,covering 12 unique risk and protective factors for SIDS across 21 countries/regions and five continents.Several risk factors,including prenatal drug exposure[eOR=7.84(95%CI=4.81–12.79),CE=highly suggestive],prenatal opioid exposure[9.55(95%CI=4.87–18.72),CE=suggestive],prenatal methadone exposure[9.52(95%CI=3.34–27.10),CE=weak],prenatal cocaine exposure[4.38(95%CI=1.95–9.86),CE=weak],prenatal maternal smoking[2.25(95%CI=1.95–2.60),CE=highly suggestive],postnatal maternal smoking[1.97(95%CI=1.75–2.22),CE=weak],bed sharing[2.89(95%CI=1.81–4.60),CE=weak],and infants found with heads covered by bedclothes after last sleep[11.01(95%CI=5.40–22.45),CE=suggestive],were identified.On the other hand,three protective factors,namely,breastfeeding[0.57(95%CI=0.39–0.83),CE=non-significant],supine sleeping position[0.48(95%CI=0.37–0.63),CE=suggestive],and pacifier use[0.44(95%CI=0.30–0.65),CE=weak],were also identified.Conclusions Based on the evidence,we propose several risk and protective factors for SIDS.This study suggests the need for further studies on SIDS-related factors supported by weak credibility,no association,or a lack of adequate research.
文摘The serotonin transporter(5‑HTT)gene has been considered one of the risk factors for sudden infant death syndrome(SIDS),but the association remains unconfirmed.This meta‑analysis was performed to quantitatively summarize the evidence for such a relationship.PubMed,EMBASE,and China National Knowledge Infrastructure databases were searched for eligible studies within a range of published years from 1990 to December 2015.The odds ratios(ORs)with 95%confidence intervals(CIs)were used to assess the different associations.A total of 8 studies with 624 cases and 796 controls were included for 5‑HTT promoter polymorphism,5 studies with 418 cases and 542 controls for intron 2,and 3 studies with 253 cases and 334 controls for haplotype.The pooled examinations showed an overall increased SIDS risk for the 5‑HTT promoter polymorphism(OR=1.65,95%CI=1.03–2.63,P=0.035 for LL vs.LS and SS;OR=1.46,95%CI=1.04–2.04,P=0.028 for L vs.S),but no association(OR=1.00,95%CI=0.75–1.33,P=0.994 for 10+9 carriers vs.12/12;OR=0.97,95%CI=0.79–1.19,P=0.753 for 10+9 vs.12)for intron 2 polymorphism,and an unreliable association(OR=0.52,95%CI=0.31–0.87,P=0.013)for S‑9 and S‑10 haplotypes.This meta‑analysis suggests that the L allele or LL homozygote of 5‑HTT promoter polymorphism has an increased risk for SIDS,while intron 2 polymorphism has no association with SIDS.
文摘Sudden Infant Death Syndrome （SIDS） is an unexpected death of infants under one year old. SIDS is the most common cause of death for infants after the first month of birth, commonly between two and four months. MEMS （Micro-Electro-Mechanical Systems） technology can be very useful to help us to avoid this horrible tragedy. In the present work, using a MEMS technology, an intelligent pacifier is designed to alarm any unusual changes in breathing during sleeping. A PZT （Piezoelectric） sensor is utilized to detect the force generated by breathing and convert it to a measurable voltage and alarm the risky breathing during infant＇s sleeping. This voltage can subsequently drive some simple alarm and make parents aware of hazard.
文摘Objective To find the pathogenesis of sudden infant death syndrome (SIDS) from changes of pulmonary surfactant. Methods By means of thin layer chromatography technique, surfactant in whole lung specimens of 10 infants with SIDS and 10 control infants without SIDS (dead of nonrespiratory diseases) were examined qualitatively and quantitatively. Results Eleven components in pulmonary surfactant were examined qualitatively, including lysophosphatidylcholine, sphingomyelin, phosphatidylcholine, phosphatidylserine, phosphatidylinositol, phosphatidylethanolamine, phosphatidylglycerol, diphosphatidylglycerol, phosphatidic acid, cholesterol and neutral lipids. Quantitative examination showed that the amount of surfactant of whole lung specimens in sudden death group [(8.9±1.0) mg/g wet lung weight] was significantly less than that in control group [(12.6±1.4) mg/g wet lung weight, P<0.01]. Qualitative variance showed that the percentages of phosphatidylcholine (49.4%±2.0%) and phosphatidylglycerol (2.6%±0.7%) decreased markedly in sudden death group compared with those in control group (61.5%±3.0% and 4.3%±1.5%, P<0.01). Conclusion Before death there is serious defect on metabolism of pulmonary surfactant in sudden death infants, with the amount decreasing and the ratio of its components being disturbed, which is one of the important pathogenies of SIDS.
文摘[提示]母乳喂养,英语叫breast-fed。母乳喂养婴儿,好处可谓多矣!首先在诞生一年之內,婴儿的死亡率就比非母乳喂养者降低了20％。别的好处也很多,比如:Other studies have shown breast-fed babies are less likely to be overweight,have fewer behavioral problems and may show differences in intelligence.They also may grow up to have lower blood pressure(血压).调查还证明,当今美国母乳喂养的婴儿占婴儿总数之70％!笔者甚至怀疑,我国是否达到了这个标准,尤其是都市年轻母亲。
文摘The infant mortality rate in China declined from 50.2‰ to 13.8‰ between 1991 and 2009.1 Although China has made good progress,there were still about 190 thousand infants who died in 2009.Reliable birth and death registration and the causes of death in populations are essential for public health planning.The National Maternal and Child Mortality Surveillance System （MCMS） is the major system to register maternal and infant deaths.It samples 126 districts and 210 counties,totally 336 sites,covering 12% of counties and 9% of the population.Causes of deaths are determined by the attending clinician.For those who die out hospital or clinic,a community health provider will be asked to visit that family and make a decision as to the cause of death.
文摘Introduction: Sub-optimal infant and early childhood feeding practices in India contribute to the high burden of child under-nutrition and infant death. Objective: To study the effect of breast-feeding duration on the survival of infants along with other demographic, socioeconomic and service related factors and to compare the decadal changes in the association. Methods: A total of 36,754 and 26,782 births less than 3 years of age from two rounds of the National Family Health Survey (NFHS) carried out in India during 1992-1993 (NFHS-1), and 2005-2006 (NFHS-3) respectively comprised the sample. Infant mortality was examined against a set of variables and breastfeeding as a time dependent covariate using multivariate extended Cox regression model. Results: Hazard of infant death observed in NFHS-3 (2005-2006) was 18 percent less [HR = 0.82;95% CI = 0.759 - 0.879] as compared to that observed in NFHS-1 (1992-1993). After adjustment of other factors, the risk of infant death was 97% less amongst children who were breastfed [HR = 0.03;95% CI = 0.029 - 0.033] as compared to those who were not breastfed. In contrast to rural area, babies belonging to urban area had an 18 percent less hazard of death during the infancy period [HR = 0.82]. Hazard of infant death was less among births to mothers with higher maternal education levels [HR = 0.93] and in those who were in gainful occupation [HR = 0.91]. The risk of infant death was higher in babies perceived to be small at birth [HR = 1.40] and belonging to states with medium post neonatal mortality rate (PNMR) [HR = 1.23;95% CI = 1.112 - 1.371] and high PNMR [HR = 1.46;95% CI = 1.327 - 1.609] in contrast to those born to women belonging to states with low post neonatal mortality. Conclusion: Promotion and implementation of evidenced based strategies are needed in India to combat the high rates of child under-nutrition and infant and child mortality.
文摘近20多年来,婴儿猝死综合征(sudden infant death syndrome,SIDS)一直是西方发达国家医学界尤其是法医学和儿科学领域研究的热点。目前,随着对SIDS广泛而深入的研究,对其病因、发病特点、危险因素以及致病机制等都有了更明确的认识。虽说近年来SIDS的发病率已有明显下降,在欧美洲、澳洲等发达国家,SIDS仍然是导致1个月到1岁婴儿死亡的首要原因。在亚洲国家和地区,尤其是发展中国家SIDS的报道很少见。本文通过总结文献并结合美国马里兰州近20年(1990—2006)来对SIDS的调查研究资料,介绍SIDS的发展历史、研究现状和新的发展趋势,并对SIDS法医学鉴定程序及鉴定要素进行讨论。
