A critical comparison of the history of sudden-death infants and infants hospitalised for near-miss for SIDS

Abstract

To determine whether significant historical differences distinguish the near-miss for Sudden Infant Death from the infants who died of SIDS, we analysed the histories and clinical data from two groups of infants seen in our University Hospital and from collaborative research group. The data were obtained with the use of a standardised questionnaire and consultation of all available medical data. Sixty-five infants were identified as near-miss for SIDS after they had suffered a severe cardiorespiratory incident during sleep for which no cause could be found despite a complete medical examination. After an autopsy had failed to reveal a cause for the unexpected death 95 cases of SIDS were retained in the study. A series of 353 variables were collected from the parents, the gynaecologists, neonatologists and attending physicians. After statistical analysis, only 15 of the 353 items studied significantly differentiated between the two groups. A step-wise discriminant analysis performed on these items led to the identification of six independent variables: the time of the incident; the circumstances leading to the observation of the child; the child's sleep position; previous minor intestinal problems; the size of the family and the mother's coffee consumption. Most variables indicate that the near-miss infants were discovered and rescued earlier than the infants who died. No other historical information appeared significantly to differentiate between the two groups of infants. These data need confirmation from a prospective epidemiological survey.

Recommended clinical evaluation of infants with an apparent life-threatening event. Consensus document of the European Society for the Study and Prevention of Infant Death, 2003

“…An ALTE can be a symptom of many disorders. As much as 50% to 70% of ALTEs are explained by some medical or surgical issue [14,27,28,29,32,42,47,48,49,54]. The main clinical diagnostic groups responsible for the ALTE, as reported in the literature, are listed in decreasing order of frequency, as follows ( Table 2).…”

“…Some history-based studies failed to outline significant differences between both ALTE and SIDS groups regarding preceding family or personal history. Infants with an ALTE were, however, 1 to 3 weeks younger than the SIDS victims and benefited more favourable circumstances at the time of the event, such as being found during daytime or sleeping supine [20,25,28,29,38,53]. If following an initial ALTE, some infants were reported with extreme cardiorespiratory events [1], a relationship with SIDS could involve only a fraction of all SIDS cases as less than 10% of future SIDS victims had presented a cyanotic or pale episode during sleep at some time before death [9,34,38,54].…”

Polysomnographic studies and home monitoring of siblings of SIDS victims and of infants with no family history of sudden infant death

“…Following completion of a standardized questionnaire [15] and a complete physical evaluation, each infant was admitted to the paediatric sleep laboratory for an all-night polysomnographic recording. Monitoring was carried out in a quiet and darkened room, at temperatures ranging from 23~176 The infants were fed and allowed their usual sleep position.…”

Síndrome de muerte súbita del lactante: prevalencia y cambios en los últimos años en Chile

“…Al igual que lo demostrado previamente en el extranjero, se pudo reconocer una serie de factores de riesgo para MS. La edad de fallecimiento fue en la mayor parte de los casos (> 80%) antes de los 2 meses de vida. La edad sería uno de los factores descritos en la "triple teoría" y otros factores de riesgo clínicos descritos por autores como Kahn y cols 16 . La triple teoría postula que la MS se debe a: una vulnerabilidad innata, edad y noxa exógena.…”