Pre- and Perinatal Clinical Characteristics of Infants Who Suffer Sudden Infant Death Syndrome

Abstract

In a population-based study, clinical and physiological data were collected in the neonatal period on 7,496 full-term (≥ 37 weeks) infants of birthweights > 2.50 kg born in 3 hospitals. The sample excluded a small number of infants who were born with severe illnesses from which there was no period of recovery before death in the neonatal period. Twenty-seven of the infants had died by the time all of the population had passed their third birthday. Twenty-one of these cases died suddenly and unexpectedly, and in 13 there was no adequate explanation for death (sudden infant death syndrome – SIDS). Pre- and early postnatal clinical data on the infants who had died were compared to a randomly selected sample of 478 survivors. This analysis showed that the infants who suffered SIDS showed similar clinical characteristics to those previously reported. Unlike the SIDS group, however, the prenatal histories of the non-SIDS deaths were similar to controls, showing no evidence of a sub-optimal intra-uterine environment.

Recurrent cyanotic episodes with severe arterial hypoxaemia and intrapulmonary shunting: a mechanism for sudden death.

“…Krypton-81m inhalation scans showed rapid but incomplete emptying of gas from each lung (37% in 5 seconds and 40% in 11 seconds for case 2, 50% in 32 seconds for patient 10; values corrected for the decay of krypton-81m).3 Intravenous krypton-81m scans during cyanotic episodes showed an increase in counts over the lung fields coinciding with an increase in mean background body counts (background increase in case 8 from 659 to 1085 (65%), in case 10 from 525 to 856 (63%), in case 22 from 487 to 685 (41%), in case 30 from 303 to 426 (41%), and in case 46 from 613 to 809 (32%)). Mean background body counts during voluntary expiratory apnoea for mean durations of 30 and 50 seconds in the two adult controls changed respectively from 129 to 135 (5%) and 70 to 76 (9%).…”

Validating the Safety of Nurse‐Health Advocate Services

“…High rates of infant mortality are undoubtedly accompanied by excess morbidity. Available information suggests that high morbidity and developmental delays occur in infants of low socioeconomic status even if they are healthy at birth (Kramer, Allen, & Gergen, 1995; Montgomery, Kiely, & Pappas, 1996; Stebbens, Alexander, & Southall, 1987; United States Department of Health and Human Services (USDHHS), 1994). Once prematurity and congenital anomalies are excluded, the primary causes of postneonatal mortality in the study communities are sudden infant death syndrome (SIDS), infections, and injuries (Barnes‐Boyd, Norr, & Nacion, 1989).…”