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Kruse SP, D'Souza L, Tuncer HGG, Stewart SE. Sources of attitudes towards parent-child co-sleeping and their effects: A systematic scoping review. FAMILY PROCESS 2024. [PMID: 38837802 DOI: 10.1111/famp.13022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 04/23/2024] [Accepted: 05/02/2024] [Indexed: 06/07/2024]
Abstract
Parent-child co-sleeping is a common practice in many cultures, although in Western countries, families who engage in parent-child co-sleeping can encounter attitudes about co-sleeping that feel critical from the people around them, as it is not commonly accepted and often stigmatized. This systematic scoping review examined and synthesized the available literature on the attitudes about parent-child co-sleeping that people encounter, their origins, and their effect on parents' own attitudes and behaviors. A total of 9796 abstracts were screened, and 33 studies were included. While the scope of the literature on this topic was narrow, this review demonstrated that parents/caregivers mostly encounter encouraging attitudes about co-sleeping from their extended family members and within their culture and discouraging attitudes from healthcare professionals. Findings suggest that encouraging attitudes enhance the likelihood of parents engaging and continuing with co-sleeping behavior, while discouraging attitudes can lead to the avoidance of parents discussing sleep with their healthcare professionals and can cause conflicts with other family members, including partners. Based on these findings, we conclude that further research is needed in several areas related to co-sleeping in Western culture, most specifically in how external attitudes influence the decision to co-sleep, as well as other behaviors and cognitions such as engagement with healthcare professionals, family satisfaction, parental self-efficacy, and overall mental health.
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Affiliation(s)
- Sarah P Kruse
- Faculty of Education, Monash University, Melbourne, Victoria, Australia
| | - Levita D'Souza
- Faculty of Education, Monash University, Melbourne, Victoria, Australia
| | - Hannah G G Tuncer
- Faculty of Education, Monash University, Melbourne, Victoria, Australia
| | - Sandra E Stewart
- Faculty of Education, Monash University, Melbourne, Victoria, Australia
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2
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Jovanovic I, Ivanovic K, Kostic S, Tadic J, Dugalic S, Petronijevic M, Gojnic M, Petronijevic M, Vrzic-Petronijevic S. Intrauterine Fetal Death in Term Pregnancy-A Single Tertiary Clinic Study. Life (Basel) 2023; 13:2320. [PMID: 38137921 PMCID: PMC10745047 DOI: 10.3390/life13122320] [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: 10/21/2023] [Revised: 11/21/2023] [Accepted: 11/29/2023] [Indexed: 12/24/2023] Open
Abstract
INTRODUCTION Intrauterine fetal death (IUFD) is defined as death of the fetus after the 20th week of gestation. Despite regular monitoring the incidence of IUFD remains high. This study aims to assess the incidence and maternal conditions associated with IUFD over term pregnancies in a twelve-year period. MATERIALS AND METHODS A retrospective descriptive study was conducted on a population of women in whom IUFD was diagnosed in a term pregnancy during the period from January 2010 to December 2022. The study was at the Clinic for Obstetrics and Gynecology, University Clinic Centre of Serbia. The analyses included the number of deliveries, live births, and stillbirths, as well as maternal, fetal, and placental conditions associated with the risk of IUDF. The statistical analysis involved descriptive statistical methods and one sample proportion. RESULTS The average age of the patients was 30 years. Most patients had secondary and higher education, and 70% of patients had regular pregnancy monitoring; 53.33% were primiparous and pregnancies occurred spontaneously. IUFD mainly occurred in the 39th week of gestation. In total, 38.3% had one to two associated diseases, 5% more than three, and 58.33% were healthy. Recurrence of IUFD was reported by 10% of patients, while 8.33% had a history of spontaneous abortion. Over 80% of placental histopathological findings indicated some pathology (e.g., infarction, infections, placental abruption). CONCLUSIONS The most significant risk factors for IUFD in term pregnancies in our population during the study period were hypertensive syndrome in pregnancy, obesity and gestational diabetes. Pathological findings on the placenta were more common in our study group than is usually reported with infractions of placental tissue being the most common, even in healthy women.
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Affiliation(s)
- Ivana Jovanovic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (K.I.); (S.K.); (S.D.); (M.P.); (M.G.); (M.P.)
- Clinic for Obstetrics and Gynecology, University Clinical Centre of Serbia, 11000 Belgrade, Serbia;
| | - Katarina Ivanovic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (K.I.); (S.K.); (S.D.); (M.P.); (M.G.); (M.P.)
- Clinic for Obstetrics and Gynecology, University Clinical Centre of Serbia, 11000 Belgrade, Serbia;
| | - Sanja Kostic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (K.I.); (S.K.); (S.D.); (M.P.); (M.G.); (M.P.)
- Clinic for Obstetrics and Gynecology, University Clinical Centre of Serbia, 11000 Belgrade, Serbia;
| | - Jasmina Tadic
- Clinic for Obstetrics and Gynecology, University Clinical Centre of Serbia, 11000 Belgrade, Serbia;
| | - Stefan Dugalic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (K.I.); (S.K.); (S.D.); (M.P.); (M.G.); (M.P.)
- Clinic for Obstetrics and Gynecology, University Clinical Centre of Serbia, 11000 Belgrade, Serbia;
| | - Milica Petronijevic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (K.I.); (S.K.); (S.D.); (M.P.); (M.G.); (M.P.)
| | - Miroslava Gojnic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (K.I.); (S.K.); (S.D.); (M.P.); (M.G.); (M.P.)
- Clinic for Obstetrics and Gynecology, University Clinical Centre of Serbia, 11000 Belgrade, Serbia;
| | - Miloš Petronijevic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (K.I.); (S.K.); (S.D.); (M.P.); (M.G.); (M.P.)
- Clinic for Obstetrics and Gynecology, University Clinical Centre of Serbia, 11000 Belgrade, Serbia;
| | - Svetlana Vrzic-Petronijevic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (K.I.); (S.K.); (S.D.); (M.P.); (M.G.); (M.P.)
- Clinic for Obstetrics and Gynecology, University Clinical Centre of Serbia, 11000 Belgrade, Serbia;
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3
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Ottaviani G, Ramos SG. Autopsy for Medical Diagnostics: Finding the Cause of Sudden Unexpected Death through Investigation of the Cardiac Conduction System by Serial Sections. Diagnostics (Basel) 2023; 13:diagnostics13111919. [PMID: 37296771 DOI: 10.3390/diagnostics13111919] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 05/27/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023] Open
Abstract
Sudden unexpected death (SUD) is a fatal event that occurs in an apparently healthy subject in a way that such an abrupt outcome could have not been predicted. SUD-including sudden intrauterine unexplained death (SIUD), sudden neonatal unexpected death (SNUD), sudden infant death syndrome (SIDS), sudden unexpected death of the young (SUDY), and sudden unexpected death in the adult (SUDA)-occurs as the first manifestation of an unknown underlying disease or within a few hours of the presentation of a disease. SUD is a major unsolved, shocking form of death that occurs frequently and can happen at any time without warning. For each case of SUD, a review of clinical history data and performance of a complete autopsy, particularly focused on the study of the cardiac conduction system, were carried out according to the necropsy protocol devised by the Lino Rossi Research Center, Università degli Studi di Milano, Italy. Research cases collected and selected for this study were represented by 75 SUD victims that were subdivided into 15 SIUD, 15 SNUD, 15 SUDY, and 15 SUDA victims. After a routine autopsy and clinical history analysis, death remained unexplained, and hence a diagnosis of SUD was assigned to 75 subjects, which included 45 females (60%) and 30 (40%) males ranging in age from 27 gestational weeks to 76 years. Serial sections of the cardiac conduction system disclosed frequent congenital alterations of the cardiac conduction system in fetuses and infants. An age-related significant difference in distribution among the five age-related groups was detected for the following anomalies of the conduction system: central fibrous body (CFB) islands of conduction tissue, fetal dispersion, resorptive degeneration, Mahaim fiber, CFB cartilaginous meta-hyperplasia, His bundle septation, sino-atrial node (SAN) artery fibromuscular thickening, atrio-ventricular junction hypoplasia, intramural right bundle branch, and SAN hypoplasia. The results are useful for understanding the cause of death for all SUD cases that were unexpected and would have otherwise remained unexplained, so as to motivate medical examiners and pathologists to perform more in-depth studies.
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Affiliation(s)
- Giulia Ottaviani
- Lino Rossi Research Center, Anatomic Pathology, Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, 20122 Milan, Italy
| | - Simone G Ramos
- Pathology and Legal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14040-900, Brazil
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Bayard D, Lersch F, Ugen G, Schaller B. Atypical trigeminocardiac reflex during intranasal dexmedetomidine sedation of a 6-month-old premature baby. BMJ Case Rep 2022; 15:e247292. [PMID: 35641083 PMCID: PMC9157338 DOI: 10.1136/bcr-2021-247292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2022] [Indexed: 11/03/2022] Open
Abstract
The trigeminocardiac reflex (TCR) is an established brainstem reflex leading to parasympathetic dysrhythmias-including haemodynamic irregularities, apnoea and gastric hypermotility-during stimulation of any sensory branches of the trigeminal nerve. Most of the clinical knowledge about TCR was gathered from general anaesthesia observations, not from procedural sedation.We present a case of a 6-month-old premature baby experiencing the reflex twice under dexmedetomidine-propofol-sedation while undergoing ophthalmic and ear examination. This was interpreted as cross-over sensitisation between the facial and trigeminal cranial nerve (N V and N VII).The present case demonstrates that different TCR subtypes can occur during the same anaesthetic procedure. Triggering TCR seems to be based on several factors and not just on a single stimulus as often presumed. Therefore, for premature babies, there is a risk for TCR under procedural sedation, and we recommend using glycopyrrolate as preventive treatment.
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Affiliation(s)
- Denise Bayard
- Department of Anaesthesiology and Pain Therapy, Inselspital, University Hospital Bern, Bern university, Bern, Switzerland
| | - Friedrich Lersch
- Department of Anaesthesiology and Pain Therapy, Inselspital, University Hospital Bern, Bern university, Bern, Switzerland
| | - Gesar Ugen
- Department of Anaesthesiology and Pain Therapy, Inselspital, University Hospital Bern, Bern university, Bern, Switzerland
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Mehboob R, Kurdi M, Ahmad M, Gilani SA, Khalid S, Nasief H, Mirdad A, Malibary H, Hakamy S, Hassan A, Alaifan M, Bamaga A, Shahzad SA. Comprehensive Analysis of Genes Associated With Sudden Infant Death Syndrome. Front Pediatr 2021; 9:742225. [PMID: 34722422 PMCID: PMC8555024 DOI: 10.3389/fped.2021.742225] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 09/13/2021] [Indexed: 12/15/2022] Open
Abstract
Background: Sudden infant death syndrome (SIDS) is a tragic incident which remains a mystery even after post-mortem investigation and thorough researches. Methods: This comprehensive review is based on the genes reported in the molecular autopsy studies conducted on SIDS so far. A total of 20 original studies and 7 case reports were identified and included in this analysis. The genes identified in children or adults were not included. Most of the genes reported in these studies belonged to cardiac channel and cardiomyopathy. Cardiac channel genes in SIDS were scrutinized for further analysis. Results: After screening and removing the duplicates, 42 unique genes were extracted. When the location of these genes was assessed, it was observed that most of these belonged to Chromosomes 11, 1 and 3 in sequential manner. The pathway analysis shows that these genes are involved in the regulation of heart rate, action potential, cardiac muscle cell contraction and heart contraction. The protein-protein interaction network was also very big and highly interactive. SCN5A, CAV3, ALG10B, AKAP9 and many more were mainly found in these cases and were regulated by many transcription factors such as MYOG C2C1 and CBX3 HCT11. Micro RNA, "hsa-miR-133a-3p" was found to be prevalent in the targeted genes. Conclusions: Molecular and computational approaches are a step forward toward exploration of these sad demises. It is so far a new arena but seems promising to dig out the genetic cause of SIDS in the years to come.
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Affiliation(s)
- Riffat Mehboob
- Research Unit, Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan.,Lahore Medical Research Center, LLP, Lahore, Pakistan
| | - Maher Kurdi
- Department of Pathology, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mursleen Ahmad
- Department of Medicine, Sahiwal Medical College, Sahiwal, Pakistan
| | - Syed Amir Gilani
- Research Unit, Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan
| | - Sidra Khalid
- Lahore Medical Research Center, LLP, Lahore, Pakistan
| | - Hisham Nasief
- Department of Obstetric and Gynecology, Faculty of Medicine, King Abdulaziz University and Hospital, Jeddah, Saudi Arabia
| | - Abeer Mirdad
- Pediatric Department, East Jeddah Hospital, Jeddah, Saudi Arabia
| | - Husam Malibary
- Department of Internal Medicine, Faculty of Medicine, King Abdul Aziz University, Jeddah, Saudi Arabia
| | - Sahar Hakamy
- Center of Excellence in Genomic Research, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Amber Hassan
- Research Unit, Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan
| | - Meshari Alaifan
- Department of Paediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ahmed Bamaga
- Paediatric Department, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia.,Neurology and Pediatric Department, Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Syed Adnan Shahzad
- Faculty of Medicine and University Hospital of Cologne, Institute of Virology, University of Cologne, Cologne, Germany
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Bednarczuk N, Milner A, Greenough A. The Role of Maternal Smoking in Sudden Fetal and Infant Death Pathogenesis. Front Neurol 2020; 11:586068. [PMID: 33193050 PMCID: PMC7644853 DOI: 10.3389/fneur.2020.586068] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 09/14/2020] [Indexed: 12/18/2022] Open
Abstract
Maternal smoking is a risk factor for both sudden infant death syndrome (SIDS) and sudden intrauterine unexplained death syndrome (SIUDS). Both SIDS and SIUDS are more frequently observed in infants of smoking mothers. The global prevalence of smoking during pregnancy is 1.7% and up to 8.1% of women in Europe smoke during pregnancy and worldwide 250 million women smoke during pregnancy. Infants born to mothers who smoke have an abnormal response to hypoxia and hypercarbia and they also have reduced arousal responses. The harmful effects of tobacco smoke are mainly mediated by release of carbon monoxide and nicotine. Nicotine can enter the fetal circulation and affect multiple developing organs including the lungs, adrenal glands and the brain. Abnormalities in brainstem nuclei crucial to respiratory control, the cerebral cortex and the autonomic nervous system have been demonstrated. In addition, hypodevelopment of the intermediolateral nucleus in the spinal cord has been reported. It initiates episodic respiratory movements that facilitate lung development. Furthermore, abnormal maturation and transmitter levels in the carotid bodies have been described which would make infants more vulnerable to hypoxic challenges. Unfortunately, smoking cessation programs do not appear to have significantly reduced the number of pregnant women who smoke.
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Affiliation(s)
- Nadja Bednarczuk
- Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, London, United Kingdom
| | - Anthony Milner
- Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, London, United Kingdom
| | - Anne Greenough
- Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, London, United Kingdom.,The Asthma UK Centre for Allergic Mechanisms of Asthma, King's College London, London, United Kingdom.,National Institute for Health Research (NIHR) Biomedical Research Centre at Guy's & St Thomas' National Health Service (NHS) Foundation Trust and King's College London, London, United Kingdom
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7
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Ottaviani G, Buja LM. Pathology of unexpected sudden cardiac death: Obstructive sleep apnea is part of the challenge. Cardiovasc Pathol 2020; 47:107221. [PMID: 32371340 DOI: 10.1016/j.carpath.2020.107221] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 03/19/2020] [Indexed: 01/03/2023] Open
Abstract
Unexpected sudden cardiac death (SCD), sudden infant death syndrome (SIDS) and sudden intrauterine unexplained death (SIUD) are major unsolved, devastating forms of death that occur frequently. Obstructive sleep apnea (OSA) has been associated with increased cardiovascular and cerebrovascular morbidity and mortality, including sudden cardiac death (SCD). This editorial will review the pathology of SCD, including sudden infant death syndrome (SIDS) and sudden intrauterine unexplained death (SIUD); OSA with its cardiovascular consequences; the possible link between SCD and OSA, discussing the potential mechanisms underlying these two frequent, but yet overlooked pathologies. Finally, the possible preventive benefits of treating OSA and identifying patients at common risk for OSA and SCD and SIDS-SIUD to prevent unexpected deaths will be discussed. Post-mortem examination is of great importance in every case of SCD sine materia, with examination of the brainstem and cardiac conduction system on serial sections, when general autopsy fails, but it should be stressed that also the investigations of patients suffering from OSA should focus on the possibility of pathological findings in common with cases of SCD.
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Affiliation(s)
- Giulia Ottaviani
- Lino Rossi Research Center, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via della Commenda, 19, 20122 Milan, Italy; Department of Pathology and Laboratory Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA.
| | - L Maximilian Buja
- Department of Pathology and Laboratory Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
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8
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Chowdhury T, Sternberg Z, Golanov E, Gelpi R, Rosemann T, Schaller BJ. Photic sneeze reflex: another variant of the trigeminocardiac reflex? FUTURE NEUROLOGY 2019. [DOI: 10.2217/fnl-2019-0007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The photic sneeze reflex (PSR) is a condition of uncontrollable sneezing episodes in response to bright light. This reflex often manifests as a mild phenomenon but may cause devastating consequences in some situations (aeroplane pilots, car drivers, etc.). Its exact mechanism is poorly understood. Interestingly, the roles of the fifth and tenth cranial nerves, brainstem nuclei and inciting patterns closely mimic a well-known brainstem reflex, known as the trigeminocardiac reflex (TCR). In this critical review, we hypothesize that the PSR can be a variant of the TCR. This concept will lead to a better understanding of the PSR and sharpens the TCR characteristics and open the doors for new research possibilities.
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Affiliation(s)
- Tumul Chowdhury
- Department of Anaesthesiology & Perioperative Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Zohara Sternberg
- Department of Neurology, Buffalo University of New York, NY, USA
| | - Eugene Golanov
- Department of Neurosurgery, Houston Methodist Hospital, Houston, TX, USA & Weill Cornell Medicine, NY, USA
| | - Riccardo Gelpi
- Department of Cardiovascular Pathophysiology, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
| | - Thomas Rosemann
- Department of Primary Care, University of Zurich, Zurich, Switzerland
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9
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Buja LM, Ottaviani G, Mitchell RN. Pathobiology of cardiovascular diseases: an update. Cardiovasc Pathol 2019; 42:44-53. [PMID: 31255975 DOI: 10.1016/j.carpath.2019.06.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 06/07/2019] [Indexed: 01/10/2023] Open
Abstract
This article introduces the Second Special Issue of Cardiovascular Pathology (CVP), the official journal of the Society for Cardiovascular Pathology (SCVP). This CVP Special Issue showcases a series of commemorative review articles in celebration of the 25th anniversary of CVP originally published in 2016 and now compiled into a virtual collection with online access for the cardiovascular pathology community. This overview also provides updates on the major categories of cardiovascular diseases from the perspective of cardiovascular pathologists, highlighting publications from CVP, as well as additional important review articles and clinicopathologic references.
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Affiliation(s)
- L Maximilian Buja
- Department of Pathology and Laboratory Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA; Cardiovascular Pathology Research Laboratory, Texas Heart Institute, CHI St. Luke's Hospital, Houston, TX, USA.
| | - Giulia Ottaviani
- Department of Pathology and Laboratory Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA; "Lino Rossi" Research Center for the study and prevention of unexpected perinatal death and sudden infant death syndrome, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Richard N Mitchell
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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10
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Elhaik E. Neonatal circumcision and prematurity are associated with sudden infant death syndrome (SIDS). J Clin Transl Res 2019; 4:136-151. [PMID: 30873502 PMCID: PMC6412606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 11/26/2018] [Accepted: 12/12/2018] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND 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. AIMS To test the predictions of the allostatic load hypothesis we explored the relationships between SIDS and two common phenotypes, male neonatal circumcision (MNC) and prematurity. METHODS 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. RESULTS SIDS mortality rate was significantly and positively correlated with MNC. Globally (weighted): Increase of 0.06 (95% CI: 0.01-0.1, t = 2.86, p = 0.01) per 1000 SIDS mortality per 10% increase in circumcision rate. US (weighted): Increase of 0.1 (95% CI: 0.03-0.16, t = 2.81, p = 0.01) per 1000 unexplained mortality per 10% increase in circumcision rate. US states in which Medicaid covers MNC had significantly higher MNC rates (χ̄ = 0.72 vs 0.49, p = 0.007) and male/female ratio of SIDS deaths (χ̄ = 1.48 vs 1.125, p = 0.015) than other US states. Prematurity was also significantly and positively correlated with MNC. Globally: Increase of 0.5 (weighted: 95% CI: 0.02-0.086, t = 3.37, p = 0.004) per 1000 SIDS mortality per 10% increase in the prematurity rates. US: Increase of 1.9 (weighted: 95% CI: 0.06-0.32, t = 3.13, p = 0.004) per 1000 unexplained mortalities per 10% increase in the prematurity rates. Combined, the phenotypes increased the likelihood of SIDS. CONCLUSIONS 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. RELEVANCE FOR PATIENTS Preterm birth and neonatal circumcision are associated with a greater risk of SIDS, and efforts should be focused on reducing their rates.
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Affiliation(s)
- Eran Elhaik
- Department of Animal and Plant Sciences, University of Sheffield, UK
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11
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Muhammad N, Sharif M, Amin J, Mehboob R, Gilani SA, Bibi N, Javed H, Ahmed N. Neurochemical Alterations in Sudden Unexplained Perinatal Deaths-A Review. Front Pediatr 2018; 6:6. [PMID: 29423392 PMCID: PMC5788892 DOI: 10.3389/fped.2018.00006] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 01/09/2018] [Indexed: 01/05/2023] Open
Abstract
Sudden unexpected perinatal collapse is a major trauma for the parents of victims. Sudden infant death syndrome (SIDS) is unexpected and mysterious death of an apparently healthy neonate from birth till 1 year of age without any known causes, even after thorough postmortem investigations. However, the incidence of sudden intrauterine unexplained death syndrome (SIUDS) is seven times higher as compared with SIDS. This observation is approximated 40-80%. Stillbirth is defined as death of a fetus after 20th week of gestation or just before delivery at full term without a known reason. Pakistan has the highest burden of stillbirth in the world. This basis of SIDS, SIUDS, and stillbirths eludes specialists. The purpose of this study is to investigate factors behind failure in control of these unexplained deaths and how research may go ahead with improved prospects. Animal models and physiological data demonstrate that sleep, arousal, and cardiorespiratory malfunctioning are abnormal mechanisms in SIUDS risk factors or in newborn children who subsequently die from SIDS. This review focuses on insights in neuropathology and mechanisms of SIDS and SIUDS in terms of different receptors involved in this major perinatal demise. Several studies conducted in the past decade have confirmed neuropathological and neurochemical anomalies related to serotonin transporter, substance P, acetylcholine α7 nicotine receptors, etc., in sudden unexplained fetal and infant deaths. There is need to focus more on research in this area to unveil the major curtain to neuroprotection by underlying mechanisms leading to such deaths.
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Affiliation(s)
- Nazeer Muhammad
- COMSATS Institute of Information Technology, Wah Cantonment, Pakistan
| | - Muhammad Sharif
- COMSATS Institute of Information Technology, Wah Cantonment, Pakistan
| | - Javeria Amin
- COMSATS Institute of Information Technology, Wah Cantonment, Pakistan
| | - Riffat Mehboob
- Research Unit, Faculty of Allied Health Sciences, University of Lahore, Lahore, Pakistan.,University Institute of Physical Therapy, Faculty of Allied Health Sciences, University of Lahore, Lahore, Pakistan
| | - Syed Amir Gilani
- Research Unit, Faculty of Allied Health Sciences, University of Lahore, Lahore, Pakistan
| | - Nargis Bibi
- COMSATS Institute of Information Technology, Wah Cantonment, Pakistan.,Department of Computer Sciences, Fatima Jinnah Women University, Rawalpindi, Pakistan
| | - Hasnain Javed
- Department of Microbiology and Molecular Genetics, University of the Punjab, Lahore, Pakistan
| | - Naseer Ahmed
- Research Unit, Faculty of Allied Health Sciences, University of Lahore, Lahore, Pakistan.,Medical School, University of Verona, Verona, Italy.,Faculty of Health Sciences, University of the Punjab, Lahore, Pakistan
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12
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Ottaviani G, Buja LM. Update on congenital heart disease and sudden infant/perinatal death: from history to future trends. J Clin Pathol 2017; 70:555-562. [DOI: 10.1136/jclinpath-2017-204326] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 03/05/2017] [Accepted: 03/08/2017] [Indexed: 11/04/2022]
Abstract
During the 20th century, expert pathologists contributed an in-depth characterisation of the anatomical pathology and associated pathophysiology of congenital heart disease (CHD). Starting in the 1970s, the reported CHD birth prevalence has been increasing, owing to advances in diagnostic methods. Over the years, surgical treatments have been associated with an enormous reduction of CHD mortality. Advances also have been made in understanding the developmental biology and molecular pathogenesis of CHD. In developed countries, sudden infant death syndrome (SIDS) is the most frequent form of death during the first year of life, with a death rate of 0.42 every 1000 births. Unexpected stillbirth has a six- to eightfold greater incidence than that of SIDS and remains unexplained in 40–80% of cases even after autopsy. Specific environmental risk factors, such as maternal smoking, air and water pollution, food contamination, pesticides, etc, can interact with the genetic constitution in complex ways, which may lead to polymorphisms and/or mutations of specific genes, such as polymorphisms in the serotonin transporter gene 5-HTT, the regulator of the synaptic serotonin concentration. Current directions of research in this area are reviewed.
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Mehboob R. Substance P/Neurokinin 1 and Trigeminal System: A Possible Link to the Pathogenesis in Sudden Perinatal Deaths. Front Neurol 2017; 8:82. [PMID: 28348544 PMCID: PMC5346962 DOI: 10.3389/fneur.2017.00082] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 02/24/2017] [Indexed: 11/13/2022] Open
Abstract
Sudden demise of a healthy fetus or a neonate is a very tragic episode in the life of parents. These deaths have been a mystery since ages but still remain unexplained. This review proposes the involvement of trigeminal nerve, neurotransmitter substance P (SP), and its receptor neurokinin 1 (NK-1R) in regulation of cardiorespiratory control in fetuses and newborns. Anomalies and immaturity of neuroregulatory systems such as trigeminal system in medulla oblongata of brainstem may provide a possible mechanism of sudden perinatal deaths. Vulnerable infants are born with respiratory center immaturity which in combination with any stressor such as cold, hypoxia, and smoking may lead to cessation of breathing and ventilatory response. SP/NK-1R may be involved in regulating the ventilatory control in neonates while it is decreased in fetal and adult life in humans, and any alterations from these may lead to irreversible sleep apnea and fatal breathing, ultimately sudden death. This review summarizes the studies performed to highlight the expression of SP or NK-1R in sudden perinatal deaths and proposes the involvement of trigeminal ganglion along with its nerve and SP/NK-1R expression alteration as one of the possible pathophysiological underlying mechanism. However, further studies are required to explore the role of SP, NK-1R, and trigeminal system in the pathogenesis of sudden infant deaths, sudden intrauterine deaths, stillbirths, and sudden deaths later in human life.
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Affiliation(s)
- Riffat Mehboob
- Biomedical Sciences, King Edward Medical University , Lahore , Pakistan
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