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Horne RS, Harrewijn I, Hunt CE. Physiology during sleep in preterm infants: Implications for increased risk for the sudden infant death syndrome. Sleep Med Rev 2024; 78:101990. [PMID: 39116607 DOI: 10.1016/j.smrv.2024.101990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 07/14/2024] [Accepted: 07/26/2024] [Indexed: 08/10/2024]
Abstract
Approximately 15 million babies are born preterm (<37 weeks of completed gestation) worldwide annually. Although neonatal and perinatal medicine have contributed to the increased survival rate of preterm newborn infants, premature infants are at increased risk of mortality in the first years of life. Infants born preterm are at four times the risk of Sudden Infant Death Syndrome (SIDS) compared to infants born at term. SIDS is believed to be multifactorial in origin. The Triple Risk hypothesis has been proposed to explain this. The model suggests that when a vulnerable infant, such as one born preterm, is at a critical but unstable developmental period in homeostatic control, death may occur if exposed to an exogenous stressor, such as being placed prone for sleep. The highest risk period is at ages 2-4 months, with 90 % of deaths occurring before 6 months. The final pathway to SIDS is widely believed to involve some combination of immature cardiorespiratory control and a failure of arousal from sleep. This review will focus on the physiological factors which increase the risk for SIDS in preterm infants and how these factors may be identified and potentially lead to effective preventative strategies.
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Affiliation(s)
| | | | - Carl E Hunt
- Uniformed Services University, Bethesda, MD, USA
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Policastro F, Yahya NB, Rossi A, Silli G, Galeoto G, Taib NI. Motor Development of Children in the Kurdistan Region of Iraq: Parent Survey. CHILDREN (BASEL, SWITZERLAND) 2024; 11:162. [PMID: 38397274 PMCID: PMC10886958 DOI: 10.3390/children11020162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 01/14/2024] [Accepted: 01/24/2024] [Indexed: 02/25/2024]
Abstract
The actual literature highlights the importance of the socio-cultural context in the development of children. However, there is a lack of specific evidence about the middle East, especially regarding the development of Kurdish children who are living in a post-war scenario, in a country which is experiencing continuous instability due to the different crises. The main aim of this study is to identify the features of the motor development of Kurdish children according to parents' opinion. A comparison with Italian children is provided as a Western example, which reflects data from the literature. In the study, 331 parents of Kurdish and Italian children aged between 3 and 7 years were involved. Parents filled the questionnaire at kindergartens, after providing consent. The questionnaire was conceptualized, designed, tested and provided ad hoc for this study; it focused on the timing of development, concerning major milestones like head control, sitting and standing-up. The questionnaire consists of 15 questions and has not been standardized yet. A logistic regression showed several differences between Kurdish and Italian children, like head control (p = 0.007) or the manipulation of big objects (p < 0.0001). These results identify the effect of the socio-cultural context and the impact of the growing environment of the child. Moreover, the results of this survey show the need for introducing different adapted, translated and validated assessment tools for motor development, considering differences related to the socio-cultural context.
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Affiliation(s)
- Francesca Policastro
- Department of Medicine and Health Science, University of Trieste, 34127 Trieste, Italy;
| | - Nizar Bakir Yahya
- College of Medicine, University of Duhok, Duhok 42001, Kurdistan Region, Iraq;
| | - Alessandra Rossi
- Italian Association for Solidarity Among People (AISPO) NGO, Duhok 42001, Kurdistan Region, Iraq;
| | - Giorgia Silli
- Department of Medicine and Health Science, University of Trieste, 34127 Trieste, Italy;
| | - Giovanni Galeoto
- Department of Human Neurosciences, Sapienza University of Rome, Neuromed IRCCS, 00185 Rome, Italy;
| | - Nezar Ismet Taib
- Department of Medical Sciences, Child and Adolescent Psychiatry, Uppsala University, 75105 Uppsala, Sweden;
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Sodini C, Paglialonga L, Antoniol G, Perrone S, Principi N, Esposito S. Home Cardiorespiratory Monitoring in Infants at Risk for Sudden Infant Death Syndrome (SIDS), Apparent Life-Threatening Event (ALTE) or Brief Resolved Unexplained Event (BRUE). Life (Basel) 2022; 12:883. [PMID: 35743914 PMCID: PMC9227273 DOI: 10.3390/life12060883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 06/07/2022] [Accepted: 06/10/2022] [Indexed: 11/29/2022] Open
Abstract
Sudden infant death syndrome (SIDS) is defined as the sudden death of an infant younger than one year of age which remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene, and review of the clinical history. About 90% of SIDS occur before six months of age, the peak incidence is between two and four months, and the median age for death is elven weeks. The clinical, social, and economic relevance of SIDS, together with the evidence that prevention of this syndrome was possible, has significantly stimulated research into risk factors for the development of SIDS in the hope of being able to introduce new effective preventive measures. This narrative review discusses the potential relationships between apparent life-threatening events (ALTE) or brief resolved unexplained events (BRUE) and SIDS development, and when a home cardiorespiratory monitor is useful for prevention of these conditions. A literature analysis showed that home cardiorespiratory monitoring has been considered a potential method to identify not only ALTE and BRUE but SIDS also. ALTE and BRUE are generally due to underlying conditions that are not detectable in SIDS infants. A true relationship between these conditions has never been demonstrated. Use of home cardiorespiratory monitor is not recommended for SIDS, whereas it could be suggested for children with previous ALTE or severe BRUE or who are at risk of the development of these conditions. However, use of home cardiorespiratory monitors assumes that family members know the advantages and limitations of these devices after adequate education and instruction in their use.
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Affiliation(s)
- Chiara Sodini
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (C.S.); (L.P.); (G.A.)
| | - Letizia Paglialonga
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (C.S.); (L.P.); (G.A.)
| | - Giulia Antoniol
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (C.S.); (L.P.); (G.A.)
| | - Serafina Perrone
- Neonatology Unit, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy;
| | | | - Susanna Esposito
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (C.S.); (L.P.); (G.A.)
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Lavezzi AM. Altered Development of Mesencephalic Dopaminergic Neurons in SIDS: New Insights into Understanding Sudden Infant Death Pathogenesis. Biomedicines 2021; 9:biomedicines9111534. [PMID: 34829763 PMCID: PMC8615170 DOI: 10.3390/biomedicines9111534] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 10/20/2021] [Accepted: 10/21/2021] [Indexed: 02/06/2023] Open
Abstract
Sudden infant death syndrome (SIDS) is defined as the unexpected sudden death of an infant under 1 year of age that remains unexplained after a thorough case investigation. The SIDS pathogenesis is still unknown; however, abnormalities in brain centers that control breathing and arousal from sleep, including dramatic changes in neurotransmitter levels, have been supposed in these deaths. This is the first study focusing on mesencephalic dopaminergic neurons, so far extensively studied only in animals and human neurological diseases, in SIDS. Dopaminergic structures in midbrain sections of a large series of sudden infant deaths (36 SIDS and 26 controls) were identified using polyclonal rabbit antibodies against tyrosine hydroxylase, the rate-limiting enzyme in catecholamine biosynthesis, and the dopamine transporter, a membrane protein specifically expressed in dopaminergic cells. Dopamine-immunolabeled neurons were observed concentrated in two specific structures: the pars compacta of the substantia nigra and in the subnucleus medialis of the periaqueductal gray matter. Anatomical and functional degenerations of dopaminergic neurons in these regions were observed in most SIDS cases but never in controls. These results indicate that dopamine depletion, which is already known to be linked especially to Parkinson's disease, is strongly involved even in SIDS pathogenesis.
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Affiliation(s)
- Anna Maria Lavezzi
- "Lino Rossi" Research Center for the Study and Prevention of Unexpected Perinatal Death and SIDS, Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
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Xu K, Fujita Y, Lu Y, Honda S, Shiomi M, Arie T, Akita S, Takei K. A Wearable Body Condition Sensor System with Wireless Feedback Alarm Functions. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2021; 33:e2008701. [PMID: 33772894 DOI: 10.1002/adma.202008701] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 01/30/2021] [Indexed: 05/21/2023]
Abstract
Emerging feedback systems based on tracking body conditions can save human lives. In particular, vulnerable populations such as disabled people, elderly, and infants often require special care. For example, the high global mortality of infants primarily owing to sudden infant death syndrome while sleeping makes request for extraordinary attentions in neonatal intensive care units or daily lives. Here, a versatile laser-induced graphene (LIG)-based integrated flexible sensor system, which can wirelessly monitor the sleeping postures, respiration rate, and diaper moisture with feedback alarm notifications, is reported. A tilt sensor based on confining a liquid metal droplet inside a cavity can track at least 18 slanting orientations. A rapid and scalable laser direct writing method realizes LIG patterning in both the in-plane and out-of-plane configurations as well as the formation of nonstick conductive structures to the liquid metal. By rationally merging the LIG-based tilt, strain, and humidity sensors on a thin flexible film, the multimodal sensor device is applied to a diaper as a real-time feedback tracking system of the sleeping posture, respiration, and wetness toward secure and comfortable lives. User-friendly interfaces, which incorporate alarming functions, provide timely feedback for caregivers tending to vulnerable populations with limited self-care capabilities.
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Affiliation(s)
- Kaichen Xu
- Department of Physics and Electronics, Osaka Prefecture University, Sakai, Osaka, 599-8531, Japan
| | - Yusuke Fujita
- Department of Physics and Electronics, Osaka Prefecture University, Sakai, Osaka, 599-8531, Japan
| | - Yuyao Lu
- Department of Physics and Electronics, Osaka Prefecture University, Sakai, Osaka, 599-8531, Japan
| | - Satoko Honda
- Department of Physics and Electronics, Osaka Prefecture University, Sakai, Osaka, 599-8531, Japan
| | - Mao Shiomi
- Department of Physics and Electronics, Osaka Prefecture University, Sakai, Osaka, 599-8531, Japan
| | - Takayuki Arie
- Department of Physics and Electronics, Osaka Prefecture University, Sakai, Osaka, 599-8531, Japan
| | - Seiji Akita
- Department of Physics and Electronics, Osaka Prefecture University, Sakai, Osaka, 599-8531, Japan
| | - Kuniharu Takei
- Department of Physics and Electronics, Osaka Prefecture University, Sakai, Osaka, 599-8531, Japan
- JST PRESTO, Kawaguchi, Saitama, 332-0012, Japan
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Crandall LG, Lee JH, Stainman R, Friedman D, Devinsky O. Potential Role of Febrile Seizures and Other Risk Factors Associated With Sudden Deaths in Children. JAMA Netw Open 2019; 2:e192739. [PMID: 31026025 PMCID: PMC6487567 DOI: 10.1001/jamanetworkopen.2019.2739] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
IMPORTANCE Sudden unexplained death in childhood (SUDC) is the fifth leading category of death among toddlers but remains underrecognized and inadequately studied. OBJECTIVE To assess the potential role of febrile seizures (FS) and other risk factors associated with SUDC and describe the epidemiology, mechanisms, and prevention of SUDC. DESIGN, SETTING, AND PARTICIPANTS This case series study reviewed 622 consecutive sudden child death cases aged 1 to 17 years from 2001 to 2017 from 18 countries. Data were collected from family members of children who died suddenly; these families voluntarily registered with the SUDC Foundation. Data analysis was conducted from November 2017 to February 2019. MAIN OUTCOME MEASURES Certified manner of death characterized as accident, natural, or undetermined. RESULTS A total of 391 families with decedents aged 1 to 6 years completed a comprehensive interview on medical and social histories, and circumstances of death with forensic evaluations revealing a cause of death (sudden explained death in childhood [SEDC]) or no cause of death (SUDC). Of these children, 231 (59.1%) were male, the mean (SD) age at death was 24.9 (12.8) months, and 104 (26.6%) had a history of FS. Compared with the general population FS prevalence (2%-5%), FS prevalence among SUDC (28.8%; 95% CI, 23.3%-34.2%) and SEDC (22.1%; 95% CI, 14.8%-29.3%) were elevated. The odds of death during sleep was 4.6-fold higher in SUDC than in SEDC cases (odds ratio, 4.61; 95% CI, 1.92-11.09; adjusted P = .008). The siblings of SUDC cases were followed up for 3144 life-years, and none died prematurely from SUDC. CONCLUSIONS AND RELEVANCE This analysis of the largest SUDC cohort confirmed an increased FS rate and found significantly increased rates of FS among SEDC. This study suggests that seizures may contribute to some SUDC and SEDC deaths. The risk of sudden death in a sibling was low. To develop and assess preventive strategies, population-based studies are needed to define the epidemiology and spectrum of risk factors and identify biomarkers of patients with FS at high risk of sudden death.
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Affiliation(s)
- Laura Gould Crandall
- Sudden Unexplained Death In Childhood Foundation, Roseland, New Jersey
- New York University School of Medicine, Comprehensive Epilepsy Center, New York
| | - Joyce H. Lee
- New York University School of Medicine, Comprehensive Epilepsy Center, New York
| | - Rebecca Stainman
- New York University School of Medicine, Comprehensive Epilepsy Center, New York
| | - Daniel Friedman
- New York University School of Medicine, Comprehensive Epilepsy Center, New York
| | - Orrin Devinsky
- New York University School of Medicine, Comprehensive Epilepsy Center, New York
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Gabbay U, Carmi D, Birk E, Dagan D, Shatz A, Kidron D. The Sudden Infant Death Syndrome mechanism of death may be a non-septic hyper-dynamic shock. Med Hypotheses 2018; 122:35-40. [PMID: 30593418 DOI: 10.1016/j.mehy.2018.10.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 10/15/2018] [Accepted: 10/20/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Sudden Infant Death Syndrome (SIDS) mechanisms of death remains obscured. SIDS' Triple Risk Model assumed coexistence of individual subtle vulnerability, critical developmental period and stressors. Prone sleeping is a major risk factor but provide no clues regarding the mechanism of death. The leading assumed mechanisms of death are either an acute respiratory crisis or arrhythmias but neither one is supported with evidence, hence both are eventually speculations. Postmortem findings do exist but are inconclusive to identify the mechanism of death. WHAT DOES THE PROPOSED HYPOTHESIS BASED ON?: 1. The stressors (suggested by the triple risk model) share a unified compensatory physiological response of decrease in systemic vascular resistant (SVR) to facilitate a compensatory increase in cardiac output (CO). 2. The cardiovascular/cardiorespiratory control of the vulnerable infant during a critical developmental period may be impaired. 3. A severe decrease in SVR is associated with hyper-dynamic state, high output failure and distributive shock. THE HYPOTHESIS Infant who is exposed to one or more stressors responds normally by decrease in SVR which increases CO. In normal circumstances once the needs are met both SVR and CO are stabilized on a new steady state. The incompetent cardiovascular control of the vulnerable infant fails to stabilize SVR which decreases in an uncontrolled manner. Accordingly CO increases above the needs to hyper-dynamic state, high output heart failure and hyper-dynamic shock. CONCLUSIONS The proposed hypothesis provides an appropriate alternative to either respiratory crises or arrhythmia though both speculations cannot be entirely excluded.
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Affiliation(s)
- Uri Gabbay
- Quality Unit, Rabin Medical Center, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Doron Carmi
- Shoham Pediatric Clinic, Southern District, Clalit Health Services, Shoham, Israel
| | - Einat Birk
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Pediatric Cardiology Unit, Schneider Children's Medical Center, Petach Tikva, Israel
| | - David Dagan
- Surgeon General's Headquarters, Israel Defense Forces, Ramat Gan, Israel
| | - Anat Shatz
- ENT, Shaare Zedek Medical Center, Jerusalem, Israel; Atid, the Israeli Society for the Study and Prevention of SIDS, Jerusalem, Israel
| | - Debora Kidron
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Pathology Department, Meir Medical Center, Kfar Saba, Israel
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Byard RW, Bright FM. Impaired motor control in SIDS infants. Int J Legal Med 2018; 132:1389. [DOI: 10.1007/s00414-018-1788-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 01/18/2018] [Indexed: 11/28/2022]
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