Sudden Infant Death Syndrome Risk Factors, Reduce the Risk of SIDS

Sudden Infant Death Syndrome Risk FactorsSudden infant death syndrome is an unexpected sudden death of an infant which remains unexplained after a thorough postmortem examination, investigation of the death scene and review of the medical history. SIDS is the most common cause of post neonatal infant mortality between one month to one year of age. The incidence of SIDS peaks between the two and four months after birth.

Sudden Infant Death Syndrome Risk Factors:

  1. Maternal and Antenatal risk factors:
  2. Young maternal age
  3. Maternal drug abuse
  4. Maternal smoking
  5. Nutritional deficiency
  6. Lower socioeconomic status
  7. Poor prenatal care
  8. Illiteracy
  9. Single marital status
  10. Higher parity
  11. Multiple Gestation
  12. Intrauterine hypoxia
  13. Fetal growth retardation
  14. Infant Risk factors:
  15. Age (peak 2-4 months)
  16. Prematurity
  17. Low birth weight
  18. Male gender
  19. Prone and side sleeping position
  20. Recent febrile illness
  21. Thermal stress
  22. Winter months
  23. Smoking exposure (prenatal and postnatal)
  24. Bottle fed babies
  25. Genetic or biological risk factors:
  26. Ventilatory responsiveness
  27. Heart rate
  28. Temperature
  29. Vagal tone
  30. Blood Pressure
  31. Respiratory pattern
  32. Family History of SIDS in a sibling
  33. Abnormal inflammatory immune response to any infection
  34. Metabolic
  35. Idiopathic apparent life threatening event

Pathophysiology of SIDS:

There is no autopsy finding pathognomonic of SIDS. There are some common observations, petechial hemorrhages are found in more than 90% of cases and may be more extensive than in other causes of infant mortality. Pulmonary odema is often present and may be substantial.

There are tissue markers indicative of pre-existing chronic low-grade asphyxia in nearly 2/3 of SIDS subjects, including persistence of adrenal brown fat, hepatic erythropoiesis, brainstem gliosis and other structural abnormalities.

Postmortem molecular analysis in SIDS cases has identified mutations on the cardiac sodium channel genetic abnormality.

Guidelines to reduce the risk of SIDS:

SIDS cannot be prevented in individual infants because it is not possible currently to prospectively identify future SIDS victims or effectively intervene. If obstructed breaths, central apnoea, bradycardia or Oxygen desaturation occurring as a part of the terminal event could be reliably detected sufficiently earlier so as to be amenable to intervention. Although prolonged QT interval of an infant may be treated if diagnosed.

  1. Full term and premature infants should be placed for sleep in the supine position. Side sleeping is not recommended.
  2. Infants should not be put to sleep on waterbeds, sofas, soft mattresses or other soft surfaces.
  3. Adults (other than parents) and children or other Siblings should not share a bed with an infant. The parent should not share a bed with their infant if they smoke or use substances such as drugs or alcohol that impair parental arousal.
  4. Overheating should be strictly avoided.
  5. The infant should be lightly clothed for sleep.
  6. Devices advertised to maintain the sleep position or to reduce the risk of rebreathing are not safe and should not be used.

Alternating the placement of the infant’s head as well as his or her orientation in the crib can also minimize the risk of head flattening.

About the Author

Leave A Response