Muerte súbita del lactante / Sudden infant death

El síndrome de muerte súbita del lactante (SMSL) consiste en la muerte inesperada de un infante menor de un año, la cual no puede ser explicada posterior a las investigaciones del caso, tales como: la anamnesis, la escena de la muerte, y la autopsia. La relevancia de este padecimiento radica en que es un fenómeno presente a nivel mundial, y es la principal causa de muerte en lactantes de 1 a 12 meses de vida. Debido a la importancia del tema, la presente investigación pretende realizar un acercamiento bibliográfico, que aborda terminología especializada; estudios de epidemiologia a nivel mundial; diversos factores de riesgo y su prevención; además del algoritmo de manejo de SMSL basado en las guías españolas de pediatría y las guías de SMSL de Massachusetts.Cabe destacar que el diagnóstico de esta muerte es de exclusión y requiere una investigación exhaustiva para poder dilucidar sus causas. Así mismo, el SMSL ha sido asociado a diferentes factores de riesgo que pueden desencadenar este evento en niños con susceptibilidad genética o adquirida, los cuales en la mayoría de los casos pueden modificarse y prevenirse educando a los padres, y a los proveedores de la salud. Debido a que el médico general, y el pediatra son los primeros profesionales en abordar al lactante y a sus familiares, es imperativo que ambos tengan conocimiento del tema en cuestión, no solo para la prevención de estos casos, sinopara el abordaje correcto en el caso que se presente una muerte súbita infantil.

Sudden Infant Death Syndrome (SIDS) is defined as the sudden death of an infant less than 1 year of age that cannot be explained after a thorough investigation is conducted, including the review of the clinical history, the examination of the death scene, and an autopsy. This condition is relevant because is a worldwide phenomenon, and it is the leading cause of death in infants between 1 to 12 months. Due to the importance of this subject, this research tries to make a bibliographic review that includes specialized terminology, worldwide epidemiology studies, risk factors, how to prevent it; and the approach, based on the Spanish and Massachusetts guidelines.The diagnosis of SIDS is based in the exclusion of causes, and requires a thorough investigation to elucidate them. Also, SIDS has been associated with different risk factors that can trigger this event in children with genetic or acquired susceptibility, which in most cases can be modified and prevented by educating the parents and the health care providers. Because the physician and the pediatrician are the first professionals to have contact with the infant and their families, it is imperative that both have knowledge of this subject, not only for the prevention of such cases, but for the correct approach in these cases.

Development of an Infants' Sleep Health Program Using a Video for SIDS Prevention Education and Measurement of the Program's Effects

PURPOSE: The purposes of this study were to develop an infant sleep health education program using a video for SIDS prevention education and to measure the effects of the program. METHODS: The infant sleep health education program consisted of presentations and motor images. The formation of educational material was directed by the systematic design of instruction. Participants in this study were 59 primiparous women from postpartum care centers. The instruments used in this study were criterion referenced test items for knowledge about infant sleep health and confidence inventory. Experimental group I was given the treatment of infant sleep health education program. Experimental group II was given the program using a video reinforcement after 2 weeks. On the other hand, control group was given no treatment. RESULTS: There was a significant increase in knowledge and confidence in the performance of mother's roles of both experimental group I and experimental group II over the control group. No significant difference was founds for knowledge and confidence in the performance of mother's roles between experimental group I and II. CONCLUSION: The results indicate that this program is a very effective intervention for better sleep health in infants by helping the mothers increase confidence in their role performance.

Sleep Position and Infant Care Practices in an Urban Community in Kuala Lumpur

Several modifiable risk factors for sudden infant death syndrome (SIDS) have been identified such as sleeping prone or on the side, sleeping on a soft surface, bed-sharing, no prenatal care and maternal ante-natal smoking. A crosssectional survey of infant sleep and care practices was conducted among parents of babies aged below 8 months to determine the prevalence and predictors of non-supine sleep position and the prevalence of other high-risk infant care practices for SIDS. Of 263 infants, 24.7% were placed to sleep in the non-supine position and age of infants was a factor positively associated with this (adjusted odds ratio 1.275, 95% CI=1.085, 1.499). The most common modifiable risk factor was the presence of soft toys or bedding in the infants’ bed or cot (89.4%). Results from this study indicate that although the predominant sleep position of Malaysian infants in this population is supine, the majority of infants were exposed to other care practices which have been shown to be associated with SIDS.

A survey of infant sleep positions associated with sudden infant death syndrome / 소아과

PURPOSE: As the prone position is thought to be an important factor in sudden infant death syndrome(SIDS), this study was conducted to contribute to reducing SIDS by analyzing sleeping positions of infants. METHODS: A face-to-face questionnaire was carried out with a total of 170 parents with a baby aged less than 6 months. RESULTS: A total of 170 infants included 95 males(55.9 percent) and 75 females(44.1 percent); their average age was 2.8 months. 45.3 percent slept in a supine position; 34.7 percent in a side or supine position; 7.1 percent in a side position; 4.7 percent in a prone position; 4.1 percent in a non-specific position. Among those in a side position, 59.7 percent were in a supine position in the morning; 19.5 percent were in the side position; 13.4 percent were in a non-specific position; and 4.1 percent were in a prone position. To the question why they slept in a specific position, 34.9 percent answered their baby slept comfortably, and particularly, 42.9 percent in the prone position group answered so. In the supine position group, 21.6 percent answered they had no reason. Both in the prone position and side position groups, 21 percent each answered they were worried about the shape of their baby's head. In the side position group, 22 percent answered that they had a fear of choking due to vomiting. In all sleeping position groups, 8.2 percent and 7.4 percent answered it was because they had a fear of suffocation and they wanted to avoid SIDS, respectively. CONCLUSION: Many of the parents preferred unstable positions, e.g. the side position and the prone position, which could cause SIDS. Their decision on their baby's sleeping position was not based on exact medical knowledge, but on convenience in taking care of their baby. As it was found that only 6 percent of the subjects were advised from their pediatrist about their baby's sleeping position, moreover, it is necessary to carry out more studies and activities for preventing SIDS caused by improper sleeping positions and educating patents about recommended sleeping positions for their baby.

Sudden Unexpected Death in Infancy: Analysis of 34 Cases Including 13 Autopsies

PURPOSE: The purpose of this study is to analyze the epidemiologic characteristics of sudden unexpected death in infancy and to evaluate the importance of postmortem autopsy. METHODS: We reviewed, retrospectively, medical records of 34 infants admitted to Kangnam General Hospital from January 1987 to December 2001 because of sudden unexpected death. We investigated the cause of death through medical history, death scene examination, autopsy findings, acylcarnitine and organic acid analysis. RESULTS: Among the total 34 infants, 18 were male(52.9%) and 16 were female(47.1%). Thirty infants(88%) were below the six months of age. Winter was the most affected season(38.2%). Eighteen infants(52.9%) died between 6 and 12AM. The prone sleeping position was observed more frequently than the supine position at death; nine cases in the prone position, six cases in the supine position. The cause of death of 23 cases could not be found by only history and death scene examination. Autopsy was done in 13 cases. Seven cases of them were thought to be SIDS. In six cases, we explained the cause of death with autosy findings. They were an endocardial fibroelastosis, a nesidioblastosis, a subdural hematoma, a bronchopneumonia and two fatty changes of liver. Metabolic screening tests performed in three cases to rule out metabolic disorder since 2000 were all normal. CONCLUSION: We concluded that autopsy and metabolic screening test should be performed to find out the cause of death in sudden unexpected death in infancy.

Forensic practice in sudden infant death syndrome / 中国法医学杂志

Sudden infant death syndrome(SIDS) has become a highlighted topic in forensic medicine and pediatrics since it was firstly defined in 1969.As some great improvements were preceded in many aspects,people know more about its features,summarization,classification and related genes.There are many reports from developed areas such as North America,Europe,Australia,Japan etc.,but few from China.This review introduces SIDS's development history,new scientific findings and discusses the feasibility of further SIDS studies and the key points in forensic practice under the influence of San Diego definition of SIDS.