Síndrome de muerte súbita del lactante / Sudden Infant Death Syndrome (SIDS)

Resumen El síndrome de muerte súbita del lactante es la principal causa de muerte infantil post neonatal en los países desarrollados. El mismo se caracteriza por una muerte repentina e inexplicable de un infante menor a un año. La compleja interacción de múltiples factores en su patogénesis se ilustra con la teoría del triple riesgo, la cual involucra un infante vulnerable en un periodo crítico de su desarrollo ante un factor de riesgo externo. Por medio de educación a los cuidadores y padres se ha documentado una disminución importante en su incidencia, aunque la misma continúa siendo muy alta.

Abstract Sudden infant death syndrome is the leading cause of post neonatal infant death in the developed countries. It is characterized for the sudden and unexplained death of an infant younger than one year old. The interaction of multiple factors in its pathogenesis is illustrated by the triple risk theory, which involves a vulnerable infant at a critical moment of its development facing an external risk factor. Through education to caregivers and parents a drop in incidence has been documented, although it is still very high.

A meta-analysis of exposure to particulate matter and adverse birth outcomes

OBJECTIVES: The objective of this study was to conduct a systematic review to provide summarized evidence on the association between maternal exposure to particulate air pollution and birth weight (BW) and preterm birth (PTB) after taking into consideration the potential confounding effect of maternal smoking. METHODS: We systematically searched all published cohort and case-control studies examining BW and PTB association with particulate matter (PM, less than or equal to 2.5μm and 10.0 μm in diameter, PM₂.₅ and PM₁₀, respectively) from PubMed and Web of Science, from January 1980 to April 2015. We extracted coefficients for continuous BW and odds ratio (OR) for PTB from each individual study, and meta-analysis was used to combine the coefficient and OR of individual studies. The methodological quality of individual study was assessed using a standard protocol proposed by Downs and Black. Forty-four studies met the inclusion criteria. RESULTS: In random effects meta-analyses, BW as a continuous outcome was negativelyassociated with 10 μg/m³ increase in PM₁₀ (-10.31 g; 95% confidence interval [CI], -13.57 to -3.13 g; I-squared=0%, p=.947) and PM₂.₅ (-22.17 g; 95% CI, -37.93 to -6.41 g; I-squared=92.3%, p<0.001) exposure during entire pregnancy, adjusted for maternal smoking. A significantly increased risk of PTB per 10 μg/m³ increase in PM₁₀ (OR, 1.23; 95% CI, 1.04 to 1.41; I-squared=0%, p=0.977) and PM2.5 (OR, 1.14; 95% CI, 1.06 to 1.22; I-squared=92.5%, p<0.001) exposure during entire pregnancy was observed. Effect size of change in BW per 10 μg/m³ increase in PM tended to report stronger associations after adjustment for maternal smoking. CONCLUSIONS: While this systematic review supports an adverse impact of maternal exposure to particulate air pollution on birth outcomes, variation in effects by exposure period and sources of heterogeneity between studies should be further explored.

A meta-analysis of exposure to particulate matter and adverse birth outcomes

OBJECTIVES: The objective of this study was to conduct a systematic review to provide summarized evidence on the association between maternal exposure to particulate air pollution and birth weight (BW) and preterm birth (PTB) after taking into consideration the potential confounding effect of maternal smoking. METHODS: We systematically searched all published cohort and case-control studies examining BW and PTB association with particulate matter (PM, less than or equal to 2.5μm and 10.0 μm in diameter, PM₂.₅ and PM₁₀, respectively) from PubMed and Web of Science, from January 1980 to April 2015. We extracted coefficients for continuous BW and odds ratio (OR) for PTB from each individual study, and meta-analysis was used to combine the coefficient and OR of individual studies. The methodological quality of individual study was assessed using a standard protocol proposed by Downs and Black. Forty-four studies met the inclusion criteria. RESULTS: In random effects meta-analyses, BW as a continuous outcome was negativelyassociated with 10 μg/m³ increase in PM₁₀ (-10.31 g; 95% confidence interval [CI], -13.57 to -3.13 g; I-squared=0%, p=.947) and PM₂.₅ (-22.17 g; 95% CI, -37.93 to -6.41 g; I-squared=92.3%, p<0.001) exposure during entire pregnancy, adjusted for maternal smoking. A significantly increased risk of PTB per 10 μg/m³ increase in PM₁₀ (OR, 1.23; 95% CI, 1.04 to 1.41; I-squared=0%, p=0.977) and PM2.5 (OR, 1.14; 95% CI, 1.06 to 1.22; I-squared=92.5%, p<0.001) exposure during entire pregnancy was observed. Effect size of change in BW per 10 μg/m³ increase in PM tended to report stronger associations after adjustment for maternal smoking. CONCLUSIONS: While this systematic review supports an adverse impact of maternal exposure to particulate air pollution on birth outcomes, variation in effects by exposure period and sources of heterogeneity between studies should be further explored.