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The influence of bed sharing on children′s physical and psychological health has been concerned as one of the main types of sleep arrangements.At present, there are significant differences in bed sharing among children of different ages, groups, regions and races.There are also studies on the impact of bed sharing sleep on children′s health, on the one hand, it is conducive to breastfeeding, where infants get enough security; on the other hand, it leads to an increase in the incidence of sudden infant death syndrome, and an increase in the number of night awakenings.Therefore, it is important to understand the current research situation of bed sharing and its influences on children, thus to better promote children healthy growth.
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ABSTRACT Objective To assess knowledge on sudden infant death syndrome (SIDS) prevention among postpartum women who received prenatal care in public and private services in Rio Grande, Rio Grande do Sul, Brazil, in 2019. Methods A cross-sectional study was conducted with postpartum women who gave birth in that municipality in 2019; the outcome was the indication of incorrect sleeping position (side/supine position) to prevent SIDS; the chi-square test was used to compare proportions between those who underwent prenatal care in public and private services. Results Among all 2,195 postpartum women, 67.7% (95%CI 65.7;69.6) were unaware of the position that prevents SIDS, 71.6% were public care service users; 77.8% of them feared choking/suffocation; 1.9% were informed about SIDS during prenatal care; doctors/nurses (70.5%) and grandmothers (65.1%) were influential regarding the baby's sleeping position. Conclusion Most postpartum women were unaware of the sleeping position that prevents SIDS, especially those receiving care in the public sector; in general, this subject is not discussed in prenatal care.
RESUMEN Objetivo Evaluar el conocimiento sobre la prevención del síndrome de muerte súbita del lactante (SMSL) entre puérperas que realizaron prenatal en servicios públicos y privados en Rio Grande, Rio Grande do Sul, Brasil, en 2019. Métodos Estudio transversal, con puérperas que dieron a luz en Rio Grande, en 2019; el resultado consistió en la indicación de posición incorrecta para dormir (lado/supino) para prevenir el SMSL; utilizando chi-cuadrado, se compararon las proporciones entre mujeres que recibieron atención prenatal en servicios públicos y privados. Resultados Entre las 2.195 puérperas, 67,7% (IC95% 65,7;69,6) desconocían como se previene el SMSL, estando el 71,6%, en la red pública; 77,8% temía asfixiarse/ahogarse; el 1,9% fue informado sobre el SMSL durante el prenatal; los médicos(as)/enfermeros(as) (70,5%) y los abuelos (65,1%) influyeron en la posición para dormir del bebé. Conclusión La mayoría de las puérperas desconocían la posición que previene el SMSL, especialmente en la red pública; en general, este tema no está cubierto en la atención prenatal.
RESUMO Objetivo Avaliar o conhecimento sobre prevenção da síndrome da morte súbita do lactente (SMSL) entre puérperas com pré-natal realizado nos serviços público e privado de Rio Grande, Rio Grande do Sul, Brasil, 2019. Métodos Estudo transversal, com puérperas do município; seu desfecho constituiuse da indicação de posição incorreta para dormir (decúbito lateral ou dorsal), visando prevenir a SMSL; utilizou-se o teste qui-quadrado para comparar proporções do desfecho e de exposição entre puérperas que realizaram pré-natal nos serviços público e privado. Resultados De 2.195 puérperas, 67,7% (IC95% 65,7;69,6), majoritariamente atendidas na rede pública (71,6%), desconheciam a posição preventiva da SMSL; 77,8% temiam engasgo/afogamento; 1,9% foram informadas sobre SMSL no pré-natal; médicos(as)/enfermeiros(as) (70,5%) e avós (65,1%) mostraram-se influentes na decisão sobre como posicionar o bebê adormecido. Conclusão A maioria das puérperas, especialmente as atendidas na rede pública, desconhecia a posição que previne SMSL; geralmente, o tema não é abordado no pré-natal.
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ABSTRACT Objective: To capacitate pregnant women to comply with measures designed to prevent sudden infant death syndrome. Methods: A quasi-experimental study was conducted before and after the intervention that included pregnant women attending the Course of Preparation for Childbirth and Parenthood of Health Centers Cluster. Six training sessions were given in the context of preventing this syndrome. Three questionnaires were applied, one to evaluate the knowledge of pregnant women before classes, other was submitted after the sessions, and another, one month after the birth of the babies, to identify what skills were acquired and which were practiced. Results: Among 77 studied pregnant women, 70 answered pre-session questionnaire and the proportion of correct answers varied from from 60.0% to 84.3%. After the intervention, 64 women answered the questionnaire and the proportion of correct answers varied between 79.7% and 100% . Prior to the intervention, the most wrong answers were related to the role of smoking as a risk factor for sudden infant death syndrome and to the use of pacifiers as a protective measure. After the sessions, all women answered correctly to the questions concerning where the baby should sleep and the safest way to lay the baby in the cradle. Conclusions: Health education with the aim of establishing measures may have a significant impact in terms of care delivery and mortality rate caused by sudden infant death syndrome.
RESUMO Objetivo: Capacitar as grávidas para o cumprimento de medidas de prevenção da síndrome de morte súbita do lactente. Métodos: Realizou-se um estudo quase-experimental pré- e pós-intervenção que integrou as grávidas que frequentavam o Curso de Preparação para o Parto e Parentalidade do Agrupamento de Centros de Saúde. Foram ministradas seis sessões formativas no âmbito da prevenção desta síndrome. Três questionários foram aplicados, um para avaliar os conhecimentos das gestantes antes das aulas, outro foi submetido após as sessões, e outro, um mês após o nascimento dos bebês para identificar que conhecimentos foram adquiridos e quais foram praticados. Resultados: Da amostra de 77 grávidas, relativamente ao questionário pré-sessão (n=70), obteve-se uma proporção de respostas corretas entre 60,0-84,3%. Posteriormente à intervenção (n=64), verificou-se um incremento dos conhecimentos com 79,7-100% de acertos. Previamente à intervenção, as respostas mais erradas às questões eram inerentes ao papel do tabagismo como fator de risco para síndrome de morte súbita do lactente e ao uso da chupeta como medida protetora. Após as sessões, todas as mulheres responderam corretamente às questões relativas ao local onde o bebê deve dormir e à forma mais segura de colocar o bebê no berço. Conclusões: Este projeto demonstrou que a educação para a saúde com o intuito de instituir medidas pode ter um impacto significativo em termos de prestação de cuidados e taxa de mortalidade por síndrome de morte súbita do lactente.
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La muerte súbita de un lactante puede ser de causa explicada, indeterminada si no se investigó en forma suficiente o inexplicada cuando una investigación completa no permite determinar su causa. La muerte súbita inexplicada, o síndrome de muerte súbita infantil, afecta en particular a las poblaciones más vulnerables. La muerte de estos niños que nacen con alteraciones del neurodesarrollo es la parte visible de una problemática que se origina en el embarazo. Disminuir la cantidad de niños vulnerables depende de políticas de salud y, sobre todo, de lograr mejorar las condiciones de vida de la población. Son acciones a largo plazo. Conocer a fondo los factores de riesgo que pueden desencadenar la muerte inesperada es lo que se puede hacer ya. La actualización de las recomendaciones sobre sueño seguro refleja nuevos conocimientos basados en la evidencia científica y un enfoque integral de los aspectos socioculturales relacionados con esta problemática.
Sudden unexpected infant death may be explained, cause by an etiology, unexplained but insufficiently investigated, or unexplained when a full investigation fails to determine the cause. Unexplained sudden death in infancy or sudden infant death syndrome particularly affects the most vulnerable populations. The death of these children who are born with alterations in their neurodevelopment is the visible part of a problem that originates in pregnancy. Reducing the number of vulnerable children depends on health policies and, above all, on improving the living conditions of the population. These are long-term actions. Knowing in depth the risk factors that can trigger unexpected death is what can be done now. The update of the recommendations on safe sleep reflects new knowledge based on scientific evidence and a comprehensive approach to the sociocultural aspects related to this problem.
Subject(s)
Humans , Pregnancy , Infant, Newborn , Infant , Sudden Infant Death/etiology , Sudden Infant Death/prevention & control , Sleep , Knowledge , Parturition , Health PolicyABSTRACT
RESUMEN La muerte súbita de un lactante puede ser de causa explicada, indeterminada -si no se investigó en forma suficiente- o inexplicada -cuando una investigación completa no permite determinar su causa-. La muerte súbita inexplicada, o síndrome de muerte súbita infantil, afecta en particular a las poblaciones más vulnerables. La muerte de estos niños que nacen con alteraciones del neurodesarrollo es la parte visible de una problemática que se origina en el embarazo. Disminuir la cantidad de niños vulnerables depende de políticas de salud y, sobre todo, de lograr mejorar las condiciones de vida de la población. Son acciones a largo plazo. Conocer a fondo los factores de riesgo que pueden desencadenar la muerte inesperada es lo que se puede hacer ya. La actualización de las recomendaciones sobre sueño seguro refleja nuevos conocimientos basados en la evidencia científica y un enfoque integral de los aspectos socioculturales relacionados con esta problemática.
ABSTRACT Sudden unexpected infant death may be explained, cause by an etiology, unexplained but insufficiently investigated, or unexplained when a full investigation fails to determine the cause. Unexplained sudden death in infancy or sudden infant death syndrome particularly affects the most vulnerable populations. The death of these children who are born with alterations in their neurodevelopment is the visible part of a problem that originates in pregnancy. Reducing the number of vulnerable children depends on health policies and, above all, on improving the living conditions of the population. These are long-term actions. Knowing in depth the risk factors that can trigger unexpected death is what can be done now. The update of the recommendations on safe sleep reflects new knowledge based on scientific evidence and a comprehensive approach to the sociocultural aspects related to this problem.
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Second-hand tobacco smoke as defined by WHO is the smoke emitted by a smoker or released from a burnt cigarette or any tobacco product. It is highly prevalent all over the globe but its serious health implications are often neglected by the public and the scientific community alike. Second-hand smoke has everlasting impact on all the body’s major organs, especially among the vulnerable population of children, pregnant ladies, people with chronic diseases and senior citizens. Although India started its war against this menace earlier than other counties, all its efforts remain bootless as its approach and implementation have a wide range of lacunae. This review aims to give a big picture of second-hand smoke, highlighting its pathophysiological changes in the body, socioeconomic impact, various strategies, and the gap that prevents these strategies from finding a favorable result in India. It becomes all the more important to reduce its impact owing to the increase in prevalence among youth reducing their vitality, derailing the society and the nation. It is recommended that the health authorities approach this health problem with utmost seriousness as a laid-back approach could welcome this silent killer’s known and unknown repercussions
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Introdução: A síndrome da morte súbita do lactente (SMSL) pode ser definida como a morte inesperada de uma criança menor de um ano durante o sono, de causa inexplicada mesmo após necrópsia. É uma condição com fatores de risco conhecidos e, em sua maioria, modificáveis. Objetivo: Destacar as evidências científicas nas quais se baseiam as recomendações da Academia Americana de Pediatria e da Sociedade Brasileira de Pediatria para prevenção da SMSL. Métodos: Revisão da literatura a partir da revisão das recomendações das sociedades para prevenção de SMSL, em busca de evidências que corroborem cada recomendação. Resultados: As recomendações para prevenção da SMSL incluem dormir em posição supina; utilizar uma superfície firme, plana e não inclinada para dormir; aleitamento materno pelo maior tempo possível; dormir no quarto dos pais nos seis primeiros meses de vida; manter o berço livre de objetos macios; oferecer a chupeta durante o sono; evitar a exposição ao tabagismo; não utilizar monitores cardiorrespiratórios. Para todas essas recomendações, foram apresentadas evidências científicas provenientes, de forma majoritária, de estudos de caso-controle. Conclusão: As recomendações para prevenção da SMSL são baseadas em evidências científicas suficientes, e é preciso que os profissionais da saúde que atendem a crianças pequenas e suas famílias estejam sempre atualizados e atentos a elas, promovendo de forma ativa a segurança do sono.
Background: Sudden Infant Death Syndrome (SIDS), defined as the unexpected death of a child under one year of age during sleep, of unexplained cause even after autopsy, is a condition with known and mostly modifiable risk factors.Objective: To highlight the scientific evidence on which the recommendations of the American Academy of Pediatrics and the Brazilian Society of Pediatrics for SIDS prevention are based. Methods: Literature review based on the societies' recommendations for SIDS prevention, searching for evidence that supports each recommendation. Results:The recommendations for SIDS prevention include placing the infant in a supine position for sleep; using a firm, flat, and non-inclined sleep surface; breastfeeding for as long as possible; room-sharing with parents for the first six months of life; keeping the crib free from soft objects; offering a pacifier during sleep; avoiding exposure to smoking; not using cardiorespiratory monitors. For all these recommendations, scientific evidence was presented, predominantly from case-control studies. Conclusion: The recommendations for SIDS prevention are based on sufficient scientific evidence, and healthcare professionals who care for young children and their families need to stay updated and attentive to them, actively promoting sleep safety.
Subject(s)
Sudden Infant Death , Child Care , Supine Position , Delivery of Health Care , Disease PreventionABSTRACT
OBJECTIVES@#The common differentially expressed mRNAs in brain, heart and liver tissues of deceased sudden infant death syndrome (SIDS) and infectious sudden death in infancy (ISDI) confirmed by autopsy was screened by bioinformatics to explore the common molecular markers and pathogenesis of SIDS and ISDI.@*METHODS@#The datasets of GSE70422 and GSE136992 were downloaded, the limma of R software was used to screen differentially expressed mRNA in different tissue samples of SIDS and ISDI decedents for overlapping analysis. The clusterProfiler of R software was used to conduct gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. The protein-protein interaction (PPI) network was constructed by STRING database, while the hub gene was screened by cytoHubba plug-in.@*RESULTS@#Compared with the control group, there were 19 significant differentially expressed genes in the tissue samples of SIDS and ISDI decedents, among which 16 in the heart tissue and 3 in the liver tissue, and the astrotactin 1 (ASTN1) gene expression difference in the heart tissue was most significant. The PPI network identified Ras homolog family member A (RHOA), integrin subunit alpha 1 (ITGA1), and H2B clustered histone 5 (H2BC5) were hub genes. The analysis of GO and KEGG showed that differentially expressed genes were enriched in the molecular pathways of actin cytoskeleton regulation, focal adhesion and response to mycophenolic acid.@*CONCLUSIONS@#ASTN1, RHOA and ITGA1 may participate in the development of SIDS and ISDI. The enrichment of differentially expressed genes in immune and inflammatory pathways suggests a common molecular regulatory mechanism between SIDS and ISDI. These findings are expected to provide new biomarkers for molecular anatomy and forensic identification of SIDS and ISDI.
Subject(s)
Humans , Infant , Gene Expression Profiling , Sudden Infant Death/genetics , Gene Regulatory Networks , Protein Interaction Maps/genetics , Computational BiologyABSTRACT
Objetivo: identificar publicações que abordam a educação em saúde relacionada à prevenção da Síndrome da Morte Súbita em Lactentes. Método: revisão integrativa realizada no PubMed, Portal Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Cochrane Reviews, Scientific Electronic Library Online e a Biblioteca Virtual em Saúde. Incluíram-se aquelas nas línguas inglesa, espanhola e portuguesa, sem recorte temporal, disponíveis gratuitamente, independentemente do delineamento. Excluíram-se duplicidades, literatura cinzenta, editoriais e cuja população eram prematuros. Resultados: identificou-se duas categorias de análise: temas para educação em saúde e barreiras e facilitadores de aderência às recomendações de prevenção. O profissional de saúde deve estimular as boas práticas de saúde, identificando barreiras e facilitadores para a adesão às recomendações. Conclusão: o profissional deve trazer a ideia de que todo bebê tem risco potencial para a síndrome da morte súbita e utilizar as estratégias disponíveis para tirá-lo da situação de vulnerabilidade.
Objectives: : to identify publications that address health education regarding the prevention of Sudden Infant Death Syndrome. Method: integrative review carried out in PubMed, Portal Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Cochrane Reviews, Scientific Electronic Library Online and the Biblioteca Virtual em Saúde. Publications in english, spanish and portuguese were included, without time frame, available for free, that addressed health education on sudden infant death syndrome, regardless of design. Those whose population was premature, duplicity, gray literature and editorials were excluded. Results: two categories of analysis were identified, namely: topics of health education and barriers and facilitators of adherence to prevention recommendations. The health professional should encourage good health practices, identifying barriers and facilitators for adherence to recommendations. The approach must be done in a collaborative and in accessible language to facilitate communication and bonding between the parties. Conclusion: the professional must be sensitive to the idea that every baby may be at potential risk and, therefore, must use the tools and strategies available to take this individual out of a situation of vulnerability- if any.
Objetivos:identificar publicaciones que aborden la educación para la salud sobre la prevención del Síndrome de Muerte Súbita del Lactente. Método: revisión integrativa realizada en PubMed, Portal Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Cochrane Reviews, Scientific Electronic Library Online y lá Biblioteca Virtual em Saúde. Se incluyeron publicaciones en inglés, español y portugués, sin límite de tiempo, disponibles de forma gratuita, que abordarán la educación en salud sobre síndrome de muerte súbita del lactente, independientemente del diseño. Se excluyeron aquellos cuya población fue prematura, duplicidad, literatura gris y editoriales. Resultados:se identificaron dos categorías de análisis, a saber: temas de educación para la salud y barreras y facilitadores de la adhesión a las recomendaciones de prevención. El profesional de la salud debe incentivar las buenas prácticas de salud, identificando barreras y facilitadores para la adherencia a las recomendaciones. El acercamiento debe hacerse de forma colaborativa y en un lenguaje accesible para facilitar la comunicación y el vínculo entre las partes. Conclusión: el profesional debe ser sensible a la idea de que todo bebé puede estar en riesgo potencial y, por lo tanto, debe utilizar las herramientas y estrategias disponibles para sacar a ese individuo de una situación de vulnerabilidad, si la hay.
Subject(s)
Humans , Male , Female , Infant, Newborn , Parents/education , Caregivers/educationABSTRACT
El chupete es un dispositivo utilizado para calmar a los lactantes y niños pequeños; sin embargo, se lo asocia a efectos nocivos. Muchas veces en la consulta los cuidadores solicitan la opinión de los profesionales de la salud sobre su uso; por este motivo, decidimos realizar una búsqueda bibliográfica de la mejor evidencia disponible. En base a la información recabada y analizada, concluimos que la introducción precoz del chupete (antes de las dos semanas de vida) no afectaría el amamantamiento hasta los seis meses, y que en niños con lactancia materna bien establecida y madres motivadas para amamantar, no influye en el destete precoz. Además existe evidencia débil a favor del uso del chupete para reducir el riesgo del síndrome de muerte súbita del lactante, mientras que su uso durante la dentición primaria se asocia al desarrollo de mordida cruzada posterior. (AU)
The pacifier is a device used to soo the infants and young children; however, it is associated with harmful effects. Many times during consultation, caregivers ask for the opinion of health professionals about its use; for this reason, we decided to perform a literature search of the best available evidence. Based on the collected and analyzed information, we concluded that the early introduction of the pacifier (before two weeks of life) would not affect breastfeeding until six months of age, and that in children with well-established breastfeeding and mothers motivated to breastfeed, it does not influence early weaning. Furthermore, there is weak evidence in favor of pacifier use to reduce the risk of sudden infant death syndrome, while its use during primary dentition is associated with the development of posterior crossbite. (AU)
Subject(s)
Humans , Male , Infant , Weaning , Breast Feeding , Pacifiers , Sudden Infant Death/prevention & control , Randomized Controlled Trials as Topic , Meta-Analysis as Topic , Risk Factors , MalocclusionABSTRACT
INTRODUCCIÓN: La Academia Americana de Pediatría recomienda que los lactantes menores de un año duerman en posición supina para prevenir el síndrome de muerte súbita en lactantes (SMSL). OBJETIVO: Describir la posición en que duermen un grupo de lactantes y factores de riesgo asociados al SMSL. SUJETOS Y MÉTODO: Estudio piloto, prospectivo concurrente, de lactantes < 45 días de vida en control sano en Centro Médico San Joaquín UC Christus. Criterios de exclusión: prematurez (edad gestacional < 37 semanas) y patología de base (respiratorias, metabólicas, cardiológicas). Se aplicó encuesta al cuidador principal respecto a datos demográficos y hábitos de sueño, basada en encuesta BISQ (Brief Screening Questionnaire for Infant Sleep Problems) validada en español, dado la inexistencia de instru mentos para < 3 meses. RESULTADOS: Se obtuvo muestra de 100 lactantes de edad 16,78 ± 12,88 días de vida, siendo 57% mujeres. La madre fue el principal informante (84%). El 79% de los lactantes dor mían en decúbito supino, 19% lo hacía de lado y 2% en prono. El 66% dormía en cuna en habitación de los padres, 31% en la cama de los padres. El 74% se quedaban dormidos durante la alimentación. El 28% de los lactantes estaban expuestos a tabaquismo pasivo. El 91% cuidadores estaba informa do sobre la posición segura de sueño, siendo el principal informante el pediatra (54%). CONCLUSIONES: En esta muestra se encontró alto porcentaje de lactantes < 45 días que duermen en posición no segura, siendo frecuente el colecho. Es importante implementar campañas locales de prevención del SMSL que refuercen el hábito de dormir seguro.
INTRODUCTION: The American Academy of Pediatrics recommends, through the implementation of the "Back to Sleep (BTS)" campaign, the supine sleeping position for infant sleeping since it prevents to prevent Sudden Infant Death Syndrome (SIDS). OBJECTIVE: To describe the sleeping position of a group of infants and the risk factors associated with sudden infant death syndrome (SIDS). SUBJECTS AND METHOD: Prospective pilot study, including infants < 45 days of life in well-child care visits at a medical center. Exclusion criteria: Preterm-born infant (gestational age < 37 weeks) and/or comorbidities (pulmonary, metabolic, cardiologic). A brief parental questionnaire was conducted regarding general demographic data and sleep habits. The questioner was based on the BISQ - Spanish version, due to the lack of validated instruments for infants < 3-month-old. RESULTS: We included a sample of 100 infants between 16.78 ± 12.88 days old (57% girls). Mothers were the main information source (84%). 79% of the infants slept in supine position, 19% slept on their sides, and 2% in prone position. Regarding the place where the infants slept, 66% did in their crib in the parents' room and 31% slept in parents' bed. 74% of infants fell asleep while being fed. 28% of infants were exposed to passive smoking at home. 91% of parents were informed about safe sleep positions, reporting that pediatricians were the main source of information (54%). CONCLUSION: We found a high percentage of infants < 45 days of life who slept in an unsafe position, and frequently co-sleep with their parents. Thus, it is important to implement local SIDS prevention campaigns to reinforce safe infant sleep.
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Sleep , Sudden Infant Death/etiology , Sudden Infant Death/prevention & control , Supine Position , Infant Care/methods , Logistic Models , Chile , Pilot Projects , Prospective Studies , Risk Factors , Practice Guidelines as Topic , Protective Factors , Infant Care/standards , Infant Care/statistics & numerical dataABSTRACT
ABSTRACT Objectives: To verify the occurrence of the risk and protective factors for sudden infant death syndrome during nursing consultation. Methods: Retrospective cohort study conducted based on medical records from a primary care unit in the municipality of São Paulo. The sample consisted of 63 infants assisted from January to December 2016. Results: The average age of infants was 3.2 months. The main risk factors identified were the presence of soft objects in the crib (93.6%) and bed sharing (58.7%). Predominant protective factors were breastfeeding (95.2%) followed by updated immunization (90.5%). Conclusions: Risk and protective factors for sudden infant death syndrome were identified in the study sample, indicating the importance of addressing the issue with families of children under 1 year of age to prevent the occurrence of such events.
RESUMEN Objetivos: Verificar la ocurrencia de factores de riesgo y de protección para la síndrome de la muerte súbita del lactante durante consulta de enfermería. Métodos: Estudio de cohorte retrospectivo conducido a partir de registros en prontuario de salud de servicio de atención primaria del municipio de São Paulo. La muestra ha sido compuesta por 63 lactantes atendidos en el período de enero a diciembre de 2016. Resultados: La media de edad de los lactantes ha sido de 3,2 meses. Los principales factores de riesgo identificados han sido la presencia de objetos blandos/suaves en la cuna (93,6%) y el compartir de lecho (58,7%). Factores de protección predominantes han sido: amamantamiento materno (95,2%) seguido de inmunización actualizada (90,5%). Conclusiones: Han sido identificados factores de riesgo y de protección para la síndrome de la muerte súbita del lactante en la muestra estudiada, indicando la importancia del abordaje de la temática junto a las familias de niños menores de 1 año, para prevención de la ocurrencia de tales eventos.
RESUMO Objetivos: Verificar a ocorrência de fatores de risco e de proteção para a síndrome da morte súbita do lactente durante consulta de enfermagem. Métodos: Estudo de coorte retrospectivo conduzido a partir de registros em prontuário de saúde de serviço de atenção primária do município de São Paulo. Amostra foi composta por 63 lactentes atendidos no período de janeiro a dezembro de 2016. Resultados: A média de idade dos lactentes foi de 3,2 meses. Os principais fatores de risco identificados foram presença de objetos macios no berço (93,6%) e o compartilhamento de leito (58,7%). Fatores de proteção predominantes foram: aleitamento materno (95,2%) seguido de imunização atualizada (90,5%). Conclusões: Foram identificados fatores de risco e de proteção para a síndrome da morte súbita do lactente na amostra estudada, indicando a importância da abordagem da temática junto às famílias de crianças menores de 1 ano, para prevenção da ocorrência de tais eventos.
ABSTRACT
ABSTRACT Objectives: To verify the occurrence of the risk and protective factors for sudden infant death syndrome during nursing consultation. Methods: Retrospective cohort study conducted based on medical records from a primary care unit in the municipality of São Paulo. The sample consisted of 63 infants assisted from January to December 2016. Results: The average age of infants was 3.2 months. The main risk factors identified were the presence of soft objects in the crib (93.6%) and bed sharing (58.7%). Predominant protective factors were breastfeeding (95.2%) followed by updated immunization (90.5%). Conclusions: Risk and protective factors for sudden infant death syndrome were identified in the study sample, indicating the importance of addressing the issue with families of children under 1 year of age to prevent the occurrence of such events.
RESUMEN Objetivos: Verificar la ocurrencia de factores de riesgo y de protección para la síndrome de la muerte súbita del lactante durante consulta de enfermería. Métodos: Estudio de cohorte retrospectivo conducido a partir de registros en prontuario de salud de servicio de atención primaria del municipio de São Paulo. La muestra ha sido compuesta por 63 lactantes atendidos en el período de enero a diciembre de 2016. Resultados: La media de edad de los lactantes ha sido de 3,2 meses. Los principales factores de riesgo identificados han sido la presencia de objetos blandos/suaves en la cuna (93,6%) y el compartir de lecho (58,7%). Factores de protección predominantes han sido: amamantamiento materno (95,2%) seguido de inmunización actualizada (90,5%). Conclusiones: Han sido identificados factores de riesgo y de protección para la síndrome de la muerte súbita del lactante en la muestra estudiada, indicando la importancia del abordaje de la temática junto a las familias de niños menores de 1 año, para prevención de la ocurrencia de tales eventos.
RESUMO Objetivos: Verificar a ocorrência de fatores de risco e de proteção para a síndrome da morte súbita do lactente durante consulta de enfermagem. Métodos: Estudo de coorte retrospectivo conduzido a partir de registros em prontuário de saúde de serviço de atenção primária do município de São Paulo. Amostra foi composta por 63 lactentes atendidos no período de janeiro a dezembro de 2016. Resultados: A média de idade dos lactentes foi de 3,2 meses. Os principais fatores de risco identificados foram presença de objetos macios no berço (93,6%) e o compartilhamento de leito (58,7%). Fatores de proteção predominantes foram: aleitamento materno (95,2%) seguido de imunização atualizada (90,5%). Conclusões: Foram identificados fatores de risco e de proteção para a síndrome da morte súbita do lactente na amostra estudada, indicando a importância da abordagem da temática junto às famílias de crianças menores de 1 ano, para prevenção da ocorrência de tais eventos.
ABSTRACT
Sudden unexpected death means a "healthy" person died suddenly of unknown diseases,usually within 6 hours after onset. It is reported that sudden unexpected death occurred from neonates(sudden infant death syndrome)to adults(sudden adult death syndrome). The patients suddenly died during daily activities,sleep or exercise. Underlying genetic diseases are main cause of sudden death. The etiological studies are performed in the patients of sudden death. Heart attack and encephalopathy due to varied genetic disorders are the two major causes. Sudden cardiac death accounts for more than half. It is known that some inherited metabolic diseases associated with sudden death sometimes. Mitochondrial diseases are a group of inherited metabolic diseases. Some patients of mitochondrial diseases suddenly died of acute heart failure,malignant arrhythmia or encephalopathy. With the advancement of genetic technology,post-mortem genetic diagnosis became available in some cases. The definite genetic diagnosis is the key for the genetic counseling of the families and prenatal diagnosis of their fetuses.
ABSTRACT
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.
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Sudden Infant Death , Infant, Newborn , Cause of Death , Infant DeathABSTRACT
Resumo Este estudo teve por objetivo conhecer a opinião das mães e identificar os fatores associados à intenção de colocar o bebê para dormir em decúbito dorsal em Rio Grande, RS. Foi aplicado questionário padronizado a todas as mães que tiveram filho nas duas únicas maternidades, entre 01/01 a 31/12/2010, e que residiam neste município. Utilizou-se teste do qui-quadrado para comparar proporções e regressão de Poisson, com ajuste robusto da variância na análise multivariável. A medida de efeito utilizada foi razão de prevalências (RP). Dentre as 2.395 (97,2% do total) mães entrevistadas, 20,5% (IC95%: 18,4%-21,6%) manifestaram intenção de colocar o bebê para dormir de barriga para cima. Esta intenção variou de 11% (IC95%: 8,1-13,7), entre mães com três ou mais filhos, a 35% (IC95% 31,1-40,2), entre aquelas com 12 anos ou mais de escolaridade. Após analise ajustada, mães de menor idade, de maior escolaridade e renda familiar, que realizaram pré-natal na rede privada, ou que tiveram três ou mais filhos, apresentaram RP significativamente maior para colocar o bebê para dormir de barriga para cima, em relação às demais. Campanhas de incentivo a esta prática devem priorizar mães de pior nível socioeconômico, de maior idade e que realizam pré-natal em unidades básicas de saúde.
Abstract This study aimed to identify mother's opinion on infant sleep position and the factors associated with the intention to place the infant in the supine position in the municipality of Rio Grande, Southern Brazil. A standardized questionnaire was applied to all mothers residing in this municipality who gave birth to a child in the only two local maternity wards from January 1 to December 31, 2010. Chi-square test was used to compare proportions, along with a Poisson regression with robust adjustment in the multivariate analysis. The effect measure used was prevalence ratio (PR). Of the 2,395 mothers interviewed (972% of the total), 20.5% (95%CI: 18.4%-21.6%) intended to place the newborn to sleep in the supine position. This prevalence varied from 11% (95%CI: 8.1-13.7) for mothers with three or more children to 35% (CI95%: 31.1-40.2) among those with 12 or more years of schooling. After adjusted analysis, younger mothers with higher education and household income who performed prenatal care in the private system or who have had three or more children had significantly higher PR to place the baby to sleep in the supine position compared to others. Campaigns encouraging this practice should focus primarily on older mothers of lower socioeconomic level and performing prenatal care in PHC facilities.
Subject(s)
Humans , Infant, Newborn , Adult , Young Adult , Sleep/physiology , Supine Position , Infant Care/methods , Mothers/statistics & numerical data , Prenatal Care/methods , Socioeconomic Factors , Brazil , Poisson Distribution , Multivariate Analysis , Age Factors , Intention , Educational Status , Income , Mothers/psychologyABSTRACT
BACKGROUND: There has been a campaign by the National Education on Sleeping Habits and Living Environment, to reduce the incidence of sudden infant death syndrome (SIDS). However, more than 100 infants die suddenly and unexplainably before the age of 1 year in Korea. Long QT syndrome (LQTS), an inheritable cardiac disease, has been reported to likely be associated with up to 14% of SIDS cases. However, genetic studies of the association between SIDS and LQTS have not yet been conducted in Korea. METHODS: We conducted genetic analysis using genomic DNA extracted from paraffin-embedded tissue blocks from 200 SIDS cases autopsied between 2005 and 2013. We analyzed the following genetic mutations associated with LQTS, KCNQ1, SCN5A, KCNE1, KCNE2, KCNJ2, and CAV3. RESULTS: Of the 200 SIDS cases, 58% involved male infants (116 male and 84 female infants, respectively), the mean age was 140 days (median, 107 days; range, 24–270 days), and they were all of Asian-Korean ethnicity. SIDS IA category criteria comprised 45 cases (22.5%) while the rest were SIDS IB. Fifteen infants (7.5%) had R1193Q in SCN5A, of doubtful pathogenicity, and no pathogenic LQTS variants were observed. CONCLUSION: This genetic investigation of LQTS in SIDS showed a low diagnostic yield. These findings suggest that LQTS molecular autopsy could be cautiously conducted in selected cases with family involvement to improve the available genetic counseling information. Meanwhile, a national SIDS registry should be established to document and evaluate the genetic risk of SIDS in Korea.
Subject(s)
Female , Humans , Infant , Male , Autopsy , DNA , Education , Genetic Counseling , Heart Diseases , Incidence , Korea , Long QT Syndrome , Retrospective Studies , Sudden Infant Death , VirulenceABSTRACT
Antecedentes: la muerte inesperada del lactante (MIL) sin asistencia, ya sea en domicilio o a su arribo al hospital conlleva a un impedimento en la firma del certificado de defunción y al necesario peritaje forense a los efectos de descartar las causas no naturales. Conocer la causa de muerte es de suma importancia no sólo para las autoridades sanitarias sino para los Pediatras a afectos actuar sobre los factores implicados. Objetivos: el objetivo de esta revisión es analizar las patologías encontradas y las circunstancias que rodearon a la muerte en los casos MIL, a los efectos de identificar factores de riesgo. Métodos: se incluyeron en este estudio 591 menores de un año fallecidos en forma súbita e inesperada, en domicilio o a su arribo a un centro asistencial, ingresados al Programa MIL, entre octubre de 1998 y diciembre de 2015, con intervalo libre 2002-2006. No todos los fallecidos en dicho período en iguales circunstancias fueron enviados para su estudio. Se reunió historia clínica, circunstancias de la muerte y la familia fue entrevistada. Los casos fueron analizados por el grupo interdisciplinario. Se clasificó como: Muerte Explicable cuando se encuentra una causa y Muerte Indeterminada cuando no se encuentra una causa. Estas últimas están constituidas por Síndrome de Muerte Súbita del Lactante (SMSL) y las Zonas Grises (ZG). Se agruparon como ZG aquellos casos en los que no había una causa que con certeza explicara la muerte, pero había factores predisponentes que pudieron causarla o favorecerla. Estas ZG fueron distribuidas en 6 categorías. Para clasificar como SMSL el grupo exige la ausencia de colecho, de decúbito prono, de almohada y de otros entornos factibles de causar sofocación. Resultados: se estudiaron 591 casos. Se identificó una causa de muerte en 339 casos (57.4%). En 252 la muerte fue indeterminada (42.6%). Se encontró infección respiratoria en 29% de los casos (50% de las muertes explicables); anomalía cardíaca en 15%; diarrea con deshidratación en 4.5%; sofocación accidental en 3%; se identificó una causa violenta en 1.5%. Hubo variación entre los dos períodos (1998-2001 y 2007-2015). De los casos indeterminados, 242 correspondieron ZG y 10 a SMSL. En 91% de las ZG menores de 4 meses de edad que tienen el dato evaluable, hubo un entorno de sueño inseguro. El colecho se observó en 72%, principalmente múltiple o asociado a decúbito prono u otros factores de riesgo. En neonatos, el 81% de las ZG evaluables, tuvo un factor de riesgo asociado a las condiciones de sueño. Conclusiones: se identificaron patologías sobre las que es posible actuar desde la prevención (infecciones respiratorias, diagnóstico prenatal de cardiopatías). En los casos indeterminados, se identificaron factores de riesgo modificables desde el primer nivel de atención con la implementación de campañas educativas y recomendaciones sobre sueño seguro dirigidas a la comunidad.
Background: sudden unexpected death in infancy (SUDI) carries an impediment to sign the death certificate. A legal autopsy is mandatory to exclude unnatural death. To know the cause of death in infancy is relevant to health authorities and paediatrics. Objectives: to investigate the pathologies and risk factors in the cases of SUDI studied. Methods: autopsies between October 1998 and December 2015 were analysed. There was a free interval (2002 to 2006). It does not include every case of SUDI in the local population. The clinical records were gathered, the circumstances of death investigated and the family was interviewed. The cases were discussed in a multidisciplinary team. The cases were classified as Explained Death or Undetermined. The undetermined deaths were classified either as Gray Zone (GZ) or SIDS cases. Six categories were considered in GZ. To consider a case as SIDS, a safe sleep environment is required; that means no co-sleeping, no prone sleeping and no pillows use that could eventually cause suffocation. Cases were coded as GZ when a clear cause of death was not identified, but abnormalities were found that could have predisposed or contributed to death. GZ were divided in 6 categories. Results: 591 cases were examined. A cause of death was identified in 339 cases (57.4%). In 252 cases, it was undetermined (42.6%). A respiratory infection was found in 29% of the autopsies (50% of the explained deaths). A cardiac anomaly was found in 15%; dehydration secondary to diarrhoea in 4.5%; suffocation in 3%; a violent cause was identified in 1.5%. There were variations between both periods (1998-2001 and 2007-2015). 252 deaths remained unexplained after the autopsy (42.6%), these were the undetermined cases. 242 were classified as Gray Zone (GZ) and 10 as SIDS cases. 91% of the evaluable GZ cases <4 months old had an unsafe sleeping environment. Co-sleeping was observed in 72% of the evaluable <4 month cases; it was mainly multiple or associated with prone sleeping position. In newborns, 81% of the evaluable ZG cases had a sleep related risk factor. Conclusions: The study improved allowed to identify pathologies amenable to intervention and prevention (respiratory infections, prenatal diagnosis of congenital heart disease). Sleep related risk factors were identified, amenable to prevention through community education programs.