NSIDRC Journal Article Alert — October 1, 2009
Prepared by the National Sudden and Unexpected Infant/Child Death and Pregnancy Loss Resource Center at Georgetown University.
These articles have been selected from PubMed, a service of the National Library of Medicine that includes over 19 million citations from MEDLINE and other life science journals for biomedical articles back to 1948. PubMed includes links to full text articles and other related resources.
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Sudden Infant Death
1. Shapiro-Mendoza CK, Kim SY, Chu SY, Kahn E, Anderson RN
Using Death Certificates to Characterize Sudden Infant Death Syndrome (SIDS): Opportunities and Limitations
J Pediatr. 2009 Sep 25. [Epub ahead of print]
Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Reproductive Health, Atlanta, GA (C.S-M., S.K., S.C., E.K.); and Centers for Disease Control and Prevention, National Center for Health Statistics, Hyattsville, MD.
OBJECTIVE: To examine cause-of-death terminology written on death certificates for sudden infant death syndrome (SIDS) and to determine the adequacy of this text data in more fully describing circumstances potentially contributing to SIDS deaths. STUDY DESIGN: With 2003 and 2004 US mortality files, we analyzed all deaths that were assigned the underlying cause-of-death code for SIDS (R95). With the terminology written on the death certificates, we grouped cases into SIDS-related cause-of-death subcategories and then assessed the percentage of cases in each subcategory with contributory or possibly causal factors described on the certificate. RESULTS: Of the 4408 SIDS-coded deaths, we subcategorized 67.2% as "SIDS" and 11.0% as "sudden unexplained (or unexpected) infant death." The terms "probable SIDS" (2.8%) and "consistent with SIDS" (4.6%) were found less frequently. Of those death certificates that described additional factors, "bedsharing or unsafe sleep environment" was mentioned approximately 80% of the time. Most records (79.4%) did not mention any additional factors. CONCLUSION: Our death certificate analysis of the cause-of-death terminology provided a unique opportunity to more accurately characterize SIDS-coded deaths. However, the death certificate was still limited in its ability to more fully describe the circumstances leading to SIDS death, indicating the need for a more comprehensive source of SIDS data, such as a case registry.
2. Thach BT
Does swaddling decrease or increase the risk for sudden infant death syndrome?
J Pediatr. 2009 Oct;155(4):461-2
Comment on
J Pediatr. 2009 Oct;155(4):475-81.
Other Infant Death
1. Kent AL, Dahlstrom JE, Ellwood D, Bourne M; ACT Perinatal Mortality Committee.Collaborators (6)
Systematic multidisciplinary approach to reporting perinatal mortality: lessons from a five-year regional review
Aust N Z J Obstet Gynaecol. 2009 Oct;49(5):472-7
McLauchlan J, Reddy S, Ham S, Freebairn L, Bombell S, Guest C.
Department of Neonatology, The Canberra Hospital, Australian National University Medical School, PO Box 11, Woden, ACT 2606, Australia. alison.kent@act.gov.au
BACKGROUND: Because of differences in reporting criteria throughout the world, comparing perinatal mortality rates and identifying areas of concern can be complicated and imprecise. AIMS: To detail the systematic approach to reporting perinatal deaths and to identify any significant differences in outcomes in the Australian Capital Territory (ACT). METHODS: Review of perinatal deaths from 2001 to 2005 in the ACT using the Australian and New Zealand Antecedent Classification of Perinatal Mortality (ANZACPM) and the Australian and New Zealand Neonatal Death Classification (ANZNDC) systems. RESULTS: ACT residents' perinatal mortality rate was 10.6 per 1000 total births, fetal death rate 7.5 per 1000 total births and neonatal death rate 3.2 per 1000 live births. The three leading antecedent causes of perinatal death were congenital anomalies, spontaneous preterm birth and unexplained antepartum death. The three leading causes of neonatal death were extreme prematurity, cardiorespiratory disorders and congenital anomalies. Multiple births attributed to 20% (65 of 321) of perinatal deaths. Perinatal autopsy was performed in 50% of cases, but in only 64% of unexplained antepartum deaths. CONCLUSIONS: Causes of perinatal death for the ACT and surrounding New South Wales region are similar to other states using this classification system. The following are considered important lessons to promote accurate perinatal mortality reporting: (i) a universal reporting system for Australia utilising a multidisciplinary team; (ii) a high perinatal autopsy rate, especially in the critical area of antepartum death with no identifiable cause; and (iii) standardised definitions for avoidability. Attention to these areas may prompt further research and changes in practice to further reduce perinatal mortality.
Miscarriage/Stillbirth/Prenatal Issues
1. Lu JR, McCowan L
A comparison of the Perinatal Society of Australia and New Zealand-Perinatal Death Classification system and relevant condition at death stillbirth classification systems
Aust N Z J Obstet Gynaecol. 2009 Oct;49(5):467-71
National Women's Health, Auckland City Hospital, Level 9, Auckland City Hospital, 2, Park Road, Grafton, Auckland, New Zealand. jyeru@hotmail.com
BACKGROUND: Stillbirths comprise two-thirds of all perinatal mortality. A classification system with low 'unexplained' stillbirth rates is important when developing prevention strategies. AIMS: This study aims to (i) determine whether the proportion of stillbirths classified as 'unexplained' is reduced, by using the relevant condition at death (ReCoDe) stillbirth classification system, compared with the Perinatal Society of Australia and New Zealand - Perinatal Death Classification (PSANZ-PDC) system; and (ii) compare the proportion of stillbirths attributed to fetal growth restriction and other causes by each system. METHODS: The ReCoDe stillbirth classification system was applied to the National Women's Health's stillbirth database for years 2004-2007. The proportion of stillbirths classified as 'unexplained' and as a result of fetal growth restriction was compared between the ReCoDe and the PSANZ-PDC systems using the chi(2) test. RESULTS: The proportion of stillbirths classified as unexplained was less with ReCoDe compared with PSANZ-PDC (8.5% (n = 26) vs 14.1% (n = 43) P = 0.04). The proportion with the primary cause attributed to fetal growth restriction was increased with ReCoDe compared with PSANZ-PDC (23.2% (n = 71) vs 8.2% (n = 25) P < 0.0001). However, 44.8% (n = 137) of all stillbirths were small for gestational age (birthweight < 10th customised centile). The most common primary cause or condition at death by both systems was congenital abnormalities. CONCLUSION: The proportion of stillbirths classified as unexplained was less with ReCoDe compared with PSANZ-PDC but rates with either method were low compared with earlier classification systems. Fetal growth restriction was listed as the primary condition more commonly with ReCoDe compared with PSANZ-PDC because of different definitions.
2. Medica I, Ostojic S, Pereza N, Kastrin A, Peterlin B
Reprod Biomed Online. 2009 Sep;19(3):406-14
Association between genetic polymorphisms in cytokine genes and recurrent miscarriage--a meta-analysis
Clinical Institute of Medical Genetics, Department of Obstetrics and Gynecology, University Medical Centre Ljubljana, Ljubljana, Slovenia.
A meta-analysis of association studies was performed to assess whether the reported genetic polymorphisms in cytokine genes are risk factors for recurrent miscarriage (RM). The electronic PubMed database was searched for case-control studies on immunity-related genes in RM. Investigations of a single polymorphism/gene involvement in RM reported more than five times were selected. Aggregating data from seven case-control studies on -308/tumour necrosis factor-alpha polymorphism, the odds ratio (OR) for RM was 1.1 (0.87-1.39) if the polymorphism was considered under a dominant genetic model. In six studies on -1082/interleukin-10 (IL-10) polymorphism, the OR under a dominant model was 0.76 (0.58-0.99), and under a recessive model the OR was 0.90 (0.71-1.15). In five case-control studies on -174/IL-6 polymorphism, the OR for RM under a recessive model was 1.29 (0.69-2.40). The results show a statistically significant association with RM for the -1082/IL-10 genotype.
3. Tzioras S, Polyzos NP, Economides DL
How do you solve the problem of recurrent miscarriage?
Reprod Biomed Online. 2009 Sep;19(3):296-7
Department of Obstetrics and Gynecology, Royal Free Hospital, London, UK. spyrostz@hotmail.com
Recurrent miscarriage is the loss of two or more consecutive pregnancies and affects 1% of couples trying to conceive. It has proven to be frustrating for both patient and clinician. The majority of investigations and treatments offered remain controversial. However, practice must be evidence based and unproven investigations and treatments should be abandoned. Psychological support is of paramount importance since a significant number of women attending RM clinics have high levels of anxiety or are clinically depressed. Setting up a RM clinic is important to provide a dedicated service to couples with RM so as to avoid unnecessary and potentially harmful treatments, and also to recruit patients in trials that will delineate causes and efficacy of treatments.
4. Robson SJ, Leader LR
Management of subsequent pregnancy after an unexplained stillbirth
J Perinatol. 2009 Sep 24. [Epub ahead of print]
Department of Obstetrics and Gynaecology, Australian National University, Canberra, Australia.
Purpose:To review the management of pregnancy after an unexplained stillbirth.Epidemiology:Approximately 1 in 200 pregnancies will end in stillbirth, of which about one-third will remain unexplained. Unexplained stillbirth is the largest single contributor to perinatal mortality. Subsequent pregnancies do not appear to have an increased risk of stillbirth, but are characterized by increased rates of intervention (induction of labor, elective cesarean section) and iatrogenic adverse outcomes (low birth weight, prematurity, emergency cesarean section and post-partum hemorrhage).Conclusions:There is no level-one evidence to guide management in this situation. Pre-pregnancy counseling is very important to detect and correct potential risk factors such as obesity, smoking and maternal disease. As timely delivery is the mainstay of management, early accurate determination of gestational age is vital. There is controversy regarding the pattern of surveillance, but evidence exists only for ultrasound and not for regular non-stress testing, nor formal fetal movement charting. There is an urgent need for more studies in this important area.Journal of Perinatology advance online publication, 24 September 2009; doi:10.1038/jp.2009.133.
5.Stanford R
Altern Ther Health Med. 2009 Sep-Oct;15(5):62-3
Recurrent miscarriage syndrome treated with acupuncture and an allergy elimination/desensitization technique
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