NSIDRC Journal Article Alert — March 28, 2008
Prepared by the National Sudden Infant Death Resource Center
at Georgetown University.
This journal article alert provides selected items added to
the National Library of Medicine’s PubMed database in
the last week.
Past issues of NSIDRC journal alerts are available at http://www.sidscenter.org.
Availability of full-text journal articles is often limited to
subscribers or through inter-library loan. Please see
your local library for copies of these articles, or view PubMed's
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Other Infant Death
1: Drevenstedt GL, Crimmins EM, Vasunilashorn S, Finch CE.
The rise and fall of excess male infant mortality.
Proc Natl Acad Sci U S A. 2008 Mar 24 [Epub ahead of print]
Davis School of Gerontology.
The male disadvantage in infant mortality underwent a surprising
rise and fall in the 20th century. Our analysis of 15 developed
countries shows that, as infant mortality declined over two
centuries, the excess male mortality increased from 10% in
1751 to >30% by approximately 1970. Remarkably, since 1970,
the male disadvantage in most countries fell back to lower
levels. The worsening male disadvantage from 1751 until 1970
may be due to differential changes in cause-specific infant
mortality by sex. Declines in infant mortality from infections
and the shift of deaths to perinatal conditions favored females.
The reduction in male excess infant mortality after 1970 can
be attributed to improved obstetric practices and neonatal
care. The additional male infants who survived because of better
conditions were more likely to be premature or have low birth
weight, which could have implications for their health in later
life. This analysis provides evidence of marked changes in
the sex ratio of mortality at an age when behavioral differences
should be minimal.
2: Widger K, Picot C.
Parents' perceptions of the quality of pediatric and perinatal
end-of-life care.
Pediatr Nurs. 2008 Jan-Feb;34(1):53-8.
Pediatric Palliative Care Service, IWK Health Centre, NS,
Canada.
OBJECTIVE: The purpose of this study was to describe the quality
of care provided before, at the time of, and following the
death of an infant, child, or adolescent from the perspective
of the parent, using a newly developed survey. SAMPLE AND METHODS:
Parents were asked to participate in this study if they experienced
a stillbirth or death of an infant/child/youth between 12 and
24 months prior to the beginning of the study. Thirty-eight
families completed the survey with one of the researchers over
the telephone or in person. Survey questions asked parents
to report on the care received rather than rate how satisfied
they were with care. RESULTS: Parents were reluctant to report
negative occurrences in care they received, yet, when questioned
further, nearly every parent could relate a particular event
or person who had a negative impact on their experience. Parents
identified communication between health professionals, relationships
with health professionals, care at the time of death, and bereavement
follow-up as problematic areas. CONCLUSION: There is room for
improvement in the end-of-life care provided to infants, children
and youth, and their families.
3: Villain E.
Indications for pacing in patients with congenital heart disease.
Pacing Clin Electrophysiol. 2008 Feb;31 Suppl 1:S17-20.
Cardiologie Pédiatrique, Université Paris V
René Descartes, Hôpital Necker-Enfants Malades,
Paris, France. elisabeth.villain@nck.aphp.fr
BACKGROUND: Advances in pacing technology have increased indications
for antibradycardia pacing and new indications have appeared
for treatment of atrial tachycardia and cardiac failure in
patients with congenital heart disease (CHD). METHODS AND RESULTS:
Implantation of a pacemaker is mandatory for symptomatic children
with complete atrio-ventricular block (CAVB). In asymptomatic
neonates and infants, prophylactic pacing is indicated when
the ventricular rhythm is <55 beats per minute (bpm) or
70 bpm in case of significant cardiac malformations. Beyond
one year of age, PM implantation is recommended in children
with an average heart rate <50 bpm or long pauses on 24-hour
recordings. Post-operative block that persists 7 days after
cardiac surgery is a class I indication for pacing. Postoperative
heart block may also be transient, but patients with residual
conduction abnormalities and a long HV interval have a high
risk of late sudden death and should be paced. After cardiac
surgery, atrial pacing may also be considered, in patients
with severe sinus bradycardia and symptoms, or in those requiring
antiarrhythmic drugs for tachy-bradycardia syndrome; in case
of failure of antiarrhythmic drugs, antitachycardia atrial
pacing now appears to be safe and efficacious. Finally, cardiac
resynchronization therapy may apply to children with congenital
heart block and cardiomyopathy, as well as to the population
with CHD. Methods and results are described in the section
dedicated to resynchronization. CONCLUSION: Cardiac pacing
indications have extended beyond prevention of sudden death
and pacemaker implantation is now indicated to improve quality
of life of patients with CHD and as a bridge to cardiac transplantation.
Miscarriage/Stillbirth/Prenatal Issues
1: Brimacombe MB, Heller DS, Zamudio S.
Comparison of fetal demise case series drawn from socioeconomically
distinct counties in new jersey.
Fetal Pediatr Pathol. 2007 Sep-Oct;26(5):213-22.
Departments of Preventive Medicine & Community Health
and School of Public Health, New Jersey Medical School - UMDNJ,
Newark, New Jersey, USA.
The causes of stillbirth were investigated in two case series
drawn from distinct communities within the same geographic
region in New Jersey, one characterized by affluence (Hackensack
Medical Center, Bergen County) and one by poverty (University
Hospital, Essex County). The data was obtained over 4 years
(1998-2001) from a stillbirth autopsy service available to
all obstetrics-gynecology clinicians in the northern New Jersey
area. A total of 52 stillbirths from University Hospital in
Newark (Essex County) and 55 from Hackensack Medical Center
(Bergen County) were examined by this same autopsy service.
Cause(s) were identified for 70% of stillbirth cases. Whereas
population-based data revealed that the rate of stillbirths
was higher in Essex and mothers of stillbirths in Essex were
of younger age, greater parity, and gravidity and had higher
rates of smoking, single marital status, and very low birth
weight infants, the only significant difference between the
two case series was infection, detected in 35% of stillbirths
from University Hospital versus 14% from Hackensack. Also no
difference in the incidence of stillbirth due to unknown cause
was found between the case series.
2: Oswal K, Agarwal A.
Warfarin-induced fetal intracranial subdural hematoma.
J Clin Ultrasound. 2008 Mar 24 [Epub ahead of print]
NCS Diagnostics, P-41, Kishore Vidya Vinode Avenue, Baghbazar,
Kolkata-700003.
Antenatal intracranial hemorrhage is a rare cause of intrauterine
fetal death, with an incidence of 4.6-5.1% in autopsy studies
of stillborn fetuses. Warfarin-associated fetal bleeding is
also a rare problem, with an incidence of 4.3% in the literature.
We present a case of warfarin-induced subdural hematoma occurring
in the second trimester. (c) 2008 Wiley Periodicals, Inc. J
Clin Ultrasound, 2008.
3: Morris JK, Savva GM.
The risk of fetal loss following a prenatal diagnosis of trisomy
13 or trisomy 18.
Am J Med Genet A. 2008 Feb 4;146A(7):827-832 [Epub ahead of
print]
Centre for Environmental and Preventive Medicine, Wolfson
Institute of Preventive Medicine, St. Bartholomew's and the
London, Queen Mary's School of Medicine and Dentistry, Charterhouse
Square, London, UK.
The objective of this study is to determine the risk of fetal
loss (spontaneous abortion or stillbirth) following a prenatal
diagnosis of trisomy 13 (T13; Patau syndrome) or trisomy 18
(T18; Edwards syndrome). Five regional congenital anomaly registers
in England and Wales provided details on the outcomes of 198
pregnancies prenatally diagnosed with T13 and 538 prenatally
diagnosed with T18. For each pregnancy the time from prenatal
diagnosis until birth, miscarriage or termination occurred
was calculated and these times were analyzed using Kaplan-Meier
survival functions. Our results showed that between 12 weeks
gestation and term an estimated 49% (95% CI: 29-73%) of pregnancies
diagnosed with T13 and 72% (61-81%) of pregnancies diagnosed
with T18 ended in a miscarriage or stillbirth. Between 18 weeks
and term the proportions were 42% (18-72%) for T13 and 65%
(57-79%) for T18 and between 24 weeks and term the proportions
were 35% (5-70%) for T13 and 59% (49-77%) for T18. Male fetuses
with T18 appeared to be more likely to be lost than female
fetuses. These are the most precise estimates currently available
for the risk of loss in a general population. These estimates
should be useful in counseling women who are carrying an affected
fetus and knowing the risk of fetal loss is essential to compare
the performance of prenatal screening programs occurring in
the first and second trimester. (c) 2008 Wiley-Liss, Inc.
4: Al Duraihimh H, Ghamdi G, Moussa D, Shaheen F, Mohsen N,
Sharma U, Stephan A, Alfie A, Alamin M, Haberal M, Saeed B,
Kechrid M, Al-Sayyari A.
Outcome of 234 Pregnancies in 140 Renal Transplant Recipients
From Five Middle Eastern Countries.
Transplantation. 2008 Mar 27;85(6):840-843.
1 Department of Medicine, King Abdulaziz Medical City, Riyadh,
Saudi Arabia. 2 Department of Medicine, Riyadh Armed Forces
Hospital, Riyadh, Saudi Arabia. 3 Department of Medicine, Jeddah
Kidney Centre, Jeddah, Saudi Arabia. 4 Department of Medicine,
Royal Hospital, Muscat, Oman. 5 Department of Medicine, Rizk
Hospital, Beirut, Lebanon. 6 Department of Medicine, King Abdulaziz
Hospital and Oncology Centre, Jeddah, Saudi Arabia. 7 Department
of Surgery, Baçskent University, Ankara, Turkey. 8 Department
of Medicine, Kidney Hospital, Damascus, Syria. 9 Department
of Medicine, Security Forces Hospital, Riyadh, Saudi Arabia.
10 Department of Medicine, King Saud Bin Abdulaziz University
for Health Sciences, Riyadh, Saudi Arabia.
OBJECTIVE.: To study the pregnancy and offspring outcomes
in postrenal transplant recipients. METHODS.: This is a retrospective
case-note review study investigating the outcome of 234 pregnancies
in 140 renal transplant recipients from five different Middle
Eastern countries. RESULTS.: Of the overall pregnancies 74.4%
were successful albeit with high prevalences of preterm and
Caesarean deliveries (40.8% and 53%, respectively). The mean
serum creatinine did not rise significantly during pregnancy
in the group as a whole but did so in patients who had serum
creatinine of or above 150 mumol/L at the beginning of their
pregnancies. The mean birth weight was (2,458 g) with 41.3%
of the newborns being of low birth weight (<2,500 g). The
prevalences of stillbirths were 7.3% and of spontaneous abortion
was 19.3%. Preeclampsia and gestational diabetes were observed
in 26.1% and 2% of pregnancies, respectively. CONCLUSIONS.:
In the presence of good allograft function, the majority of
pregnancies in renal transplant recipients have a good outcome
but with increased incidence of preeclampsia, reduced gestational
age, and low birth weights. Patients with baseline serum creatinine
of above 150 mumol/L have an increased risk of allograft dysfunction
resulting from the pregnancy.
Prepared by the
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