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NSIDRC Journal Article Alert — October 30, 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.
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 How to Get the Journal Article for more details.
Sudden Infant Death
1. Highet AR, Gibson CS, Goldwater PN
Clostridium sordellii lethal toxin gene is not detectable by PCR in the intestinal flora of Sudden Infant Death Syndrome cases or infants who died of other causes
J Med Microbiol. 2009 Oct 22. [Epub ahead of print]
1 SA Pathology at the Women's and Childrens Hospital;
Infection caused by Clostridium sordellii translocated from the gastrointestinal tract has been reported to cause septic shock, often resulting in fatality. The organism's major virulence factor, lethal toxin (LT), is responsible for fatal outcome after C. sordellii infection. We designed an experiment to explore the possibility of C. sordellii colonising the intestinal tract contributing to Sudden Infant Death Syndrome, possibly via a fatal toxaemia. The feasibility of the methodology was demonstrated using a spiked culture of intestinal contents. Cultures grown from intestinal contents of fifty infants meeting the 1991 definition of SIDS, and thirteen cases of non-SIDS death were tested for the LT gene by PCR. None of the SIDS or non-SIDS infant samples tested positive for LT. The results of this investigation suggest that intestinal colonization by LT toxigenic C. sordellii is unlikely to contribute to SIDS. However, based on these results alone we cannot completely exclude the role of C. sordellii bacteraemia or toxaemia in SIDS.
2. Aslam H, Kemp L, Harris E, Gilbert E
Socio-cultural perceptions of sudden infant death syndrome among migrant Indian mothers
J Paediatr Child Health. 2009 Oct 19. [Epub ahead of print]
Centre for Health Equity Training Research and Evaluation (CHETRE), part of the Centre for Primary Health Care and Equity, School of Public Health and Community Medicine, University of NSW, Liverpool Hospital, Liverpool BC, New South Wales, Australia.
Aim: To explore socio-cultural influences on migrant mother decisions and beliefs regarding co-sleeping as a risk factor for sudden infant death syndrome (SIDS). Methods: Semi-structured interviews with five Indian-born women in a socio-economically disadvantaged suburb in the south-west of Sydney were conducted between September and December 2007. Transcripts were analysed using principles of discourse analysis. Results: Discourse analysis revealed that SIDS-related decisions and beliefs about co-sleeping as a risk factor for SIDS are constructed amid competing discourses of motherhood and child health. Mothers are either actively or unconsciously deciding how they negotiate or resist dominant Western discourses of motherhood and child health to make 'the best' health-related decisions for their children. Participants resisted acknowledging child sleep practices recommended by health practitioners, particularly recommendations to put to sleep the baby in its own cot. This resistance was expressed by constructing messages as 'inapplicable' and 'inappropriate'. Co-sleeping was constructed as a highly valued practice for its physical and social benefits to the child, mother and family by facilitating child security, breastfeeding, bonding and family connectedness. Conclusion: This study illustrates how decisions and behaviour are shaped by socio-cultural influences embedded in discourses and context. It also shows that in-depth investigation through a social constructivist lens is particularly useful for investigating influences on knowledge acquisition, interpretation and implementation among migrant groups. A greater appreciation of the social meanings and ideologies attached to behaviours can help to ensure that the correct messages reach the correct populations, and that child health outcomes can be achieved and maintained both for overseas and Australian-born populations.
Miscarriage/Stillbirth/Prenatal Issues
1. Levine K, Cameron ST
Women's preferences for method of abortion and management of miscarriage
J Fam Plann Reprod Health Care. 2009 Oct;35(4):233-5
University of Edinburgh, Edinburgh, UK.
BACKGROUND AND METHODOLOGY: There is growing interest in the UK towards increasing treatment options for women undergoing abortion and miscarriage. Such options include home medical treatment and surgery under local anaesthesia (LA). This study aimed to gauge views of women undergoing abortion and treatment for miscarriage at the Royal Infirmary Edinburgh towards medical treatment at home, and surgery under LA, to determine whether new services should be developed. The study consisted of a self-administered anonymous questionnaire. RESULTS: A total of 148 questionnaires were completed by women undergoing a medical abortion (n = 97; 66%), surgical abortion (n = 30; 20%) or surgical management of miscarriage (n = 21; 14%). Women having an abortion expressed a future preference for medical abortion in hospital (n = 64; 52%) at home (n = 31; 25%) or by surgery under general anaesthesia (GA) (n = 20; 17%) or LA (n = 7; 6%). Women having a miscarriage expressed a future preference for surgery under GA (n = 7; 35%), LA (n = 6; 30%) or medical management at home (n = 4; 20%) or in hospital (n = 3; 15%). CONCLUSIONS: This study shows that medical abortion at home is a potentially popular choice for women having an abortion, with surgical abortion under LA less so. Both home medical management and surgery under LA would appear to be welcome service developments for women needing treatment for a miscarriage.
2. Bohlmann MK, Luedders DW, Strowitzki T, von Wolff M
Specific secretory phase endometrial leukocytes of women with two and more consecutive idiopathic abortions are not significantly different from healthy controls
Arch Gynecol Obstet. 2009 Jul 15. [Epub ahead of print]
Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany, michael.bohlmann@uk-sh.de.
OBJECTIVE: To analyze concentrations of endometrial leukocytes in patients with idiopathic-repeated abortions. MATERIALS AND METHODS: Biopsies of exactly dated secretory endometrium in 25 patients with idiopathic-repeated abortions and 10 control patients without a history of miscarriage were compared with respect to the concentrations of T-helper cells (CD4), cytotoxic T-cells (CD8), B-cells (CD19) and uterine natural killer cells (CD56) by immunohistochemistry and RNase protection assays. RESULTS: All examined cells were detectable within secretory endometrium. No statistically significant differences of the examined immune-cell concentrations were seen between the control group and the repeated miscarriage group by either test. CONCLUSION: This study suggests that the concentrations of specific endometrial leukocytes in a non-pregnant cycle are not associated with repeated pregnancy loss. Thus, the hypothesis of an altered endometrial immunity in patients with repeated miscarriages, symbolized by persistently differing local immune-cell concentrations, has to be questioned.
3. Ammon Avalos L, Kaskutas LA, Block G, Li DK
Do multivitamin supplements modify the relationship between prenatal alcohol intake and miscarriage?
Am J Obstet Gynecol. 2009 Oct 19. [Epub ahead of print]
School of Public Health, University of California, Berkeley, Berkeley, CA; Alcohol Research Group, Emeryville, CA.
OBJECTIVE: To determine whether multivitamin supplements modify the relationship between alcohol consumption during pregnancy and the risk of miscarriage. STUDY DESIGN: We used data from a population-based cohort study of pregnant women (n = 1061; response rate = 39%). Participants were asked about their alcohol consumption and vitamin intake during pregnancy. RESULTS: Among multivitamin nonusers, women who drank alcohol during their pregnancy were more likely to have a miscarriage compared with women who abstained (adjusted hazard ratio, 1.67; 95% confidence interval, 1.04-2.69). However, among multivitamin users, there was no difference in the risk of miscarriage between alcohol consumers and abstainers. Results suggest the volume of alcohol as well as the timing of multivitamin supplementation may also be important. CONCLUSION: Our findings suggest that a woman of childbearing years might decrease her risk of miscarriage associated with alcohol intake by taking multivitamin supplements. However, our findings should be interpreted with caution and future research replicating these findings is necessary.
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Loss Resource Center
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