SIDS

This baby had the vaccines at 1:00 and by 4: 00 the baby is dead, yet ' SIDS' is the cause of death.

Vaccinations Manufacturer Lot Dose Route Site
1 DTAP NORTH AMERICAN V 1004R 1 IM RL
2 HIBV LEDERLE(PRAXIS) 512453A 1 IM RL
3 IPV MERIEUX INST P0474 1 IM LL

Onset Date: 2000-04-06 Number of Days: 0
Symptoms: APNEA BRONCHIOLITIS BRONCHITIS CHILLS EDEMA LUNG HEART ARREST HYPOTONIA LUNG DIS RHINITIS SIDS
Child presented to ER, lifeless and not breathing. Baby cool with rigor mortis. Mom had fed infant at 13:30 and he was fine. At 17:00, noted to be pale and lifeless. CPR began and brought to ER. Autopsy shows pulmonary vascular congestion, pulmonary edema, tracheobronchitis with bronchiolotis and peri-bronchiolar pulmonary inflammation, generalized visceral congestion, sudden infant death

Maternal and Obstetric Risk Factors for Sudden Infant Death Syndrome in the United States
Darios Getahun, MD, MPH*, Devendra Amre, MD, PhD, George G. Rhoads, MD, MPH and Kitaw Demissie, MD, PhD

From the *Department of Family Medicine, University of Medicine and Dentistry (UMDNJ)-Robert Wood Johnson Medical School, New Brunswick, New Jersey; Department of Pediatrics, Research Center, Sainte-Justine Hospital, Montreal, Quebec, Canada; Division of Epidemiology, UMDNJ–School of Public Health, Piscataway, New Jersey; and Department of Environmental and Community Medicine, UMDNJ–Robert Wood Johnson Medical School, Piscataway, New Jersey.

Address reprint requests to: Darios Getahun, MD, MPH, Department of Family Medicine, UMDNJ-Robert Wood Johnson Medical School, One Robert Wood Johnson Place-CN 19, New Brunswick, NJ 08903-0019; e-mail: getahuda@umdnj.edu.

OBJECTIVE: The objectives of this study were to 1) study the incidence of sudden infant death syndrome (SIDS) among singleton births in the United States and 2) identify maternal and obstetric risk factors for SIDS.

METHODS: A cohort of all live births in the United States from 1995 to 1998, formed the source population (n = 15,627,404). The data were obtained from the National Centers for Health Statistics Linked Births and Infant Deaths File. A nested case-control study was used to examine risk factors for SIDS. From this birth cohort, all SIDS deaths (n = 12,404) were first identified (case group). From the remaining non-SIDS births, a 4-fold larger sample (n = 49,616) was randomly selected as a control group.

RESULTS: The overall incidence of SIDS was 81.7 per 100,000 live births. More mothers in the case group than in the control group were reported to have placenta previa (odds ratio [OR]: 1.70; 95% confidence interval [CI] 1.24, 2.33), abruptio placentae (OR 1.57; 95% CI 1.24, 1.98), premature rupture of membranes (OR 1.48; 95% CI 1.33, 1.66), or small for gestational age (OR 1.40; 95% CI 1.30, 1.50 for the 10th percentile). SIDS cases were also more likely to be male. Mothers of cases were more likely to be younger, less educated, and nonwhite, and more of them smoked during pregnancy and did not attend prenatal care.

CONCLUSION: This analysis confirms the importance of several well known demographic and lifestyle risk factors for SIDS. In addition, placental abnormalities were risk factors for SIDS.

July 30, 2008

WebMD) Despite little change in overall infant death rates in recent years, a CDC report shows that deaths directly related to preterm births have increased, especially for non-Hispanic black women.

Researchers considered a baby's death preterm-related if the cause occurred in more than 75% of infants born before 37 weeks gestation and the death was a direct result of being born too early.

The report by the CDC's division of vital statistics links infant death records to birth information. The most recent statistics revealed few fluctuations in the overall U.S. infant mortality rate from 2004 to 2005 (6.78 deaths per 1,000 live births vs. 6.86 deaths per 1,000 live births.)

Overall death rates were lowest for babies born to mothers of Central and South American (4.68 per 1,000) and Asian or Pacific Islander origin (4.89 per 1,000) and highest for non-Hispanic black mothers (13.63 per 1,000.) Among Hispanics, infant mortality rates ranged from 4.42 for mothers of Cuban descent to 8.30 for women of Puerto Rican origin.

However, preterm-related infant deaths jumped from 2000 to 2005 (34.6% to 36.5%).

Babies born to non-Hispanic black women were 3.4 times more likely to die from preterm-related causes than were non-Hispanic white women. The preterm-related infant mortality rate for Puerto Rican mothers was 87% higher than that seen in non-Hispanic white moms.

Doctors have seen a steady increase in the number of preterm and low-birth-weight births since the mid-1980s, according to background information in the report. Some of this is attributed to a rise in multiple births, in part due to more frequent use of fertility treatments, and to an increase in the number of women having C-sections and labor induced before the baby is full term.

(or the hep b vaccine at birth?)

In 2005, low birth weight or preterm babies were born more often to non-Hispanic black mothers than women of other origin. Mothers of Mexican origin had the lowest rates of low-birth-weight babies, and Asian or Pacific Islander mothers had the lowest rates of preterm births (10.7%).

"The differences in low birth weight and preterm births are major factors in the differences in infant mortality rates by race and ethnicity," the CDC researchers write in their report.

More than half of all infant deaths in the U.S. in 2005 occurred in babies born extremely early -- before 32 weeks gestation. Babies born slightly premature (34-36 weeks gestation) had three times the infant death rate than infants born 37 weeks or later. The leading causes of infant death were birth defects, low birth weight, and sudden infant death syndrome (SIDS).

Other factors linked to higher infant death rates included multiple deliveries (twins, triplets, or more), and mothers who were unmarried or born in the 50 states and Washington, D.C. Infant death rates were higher among boys than girls.
http://www.cbsnews.com/stories/2008/07/29/health/webmd/main4304579.shtml

By Kelli Stacy
Reviewed by Louise Chang
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