NSIDRC Journal Article Alert — March 19, 2010
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. Richardson HL, Walker AM, S C Horne R
Influence of Swaddling Experience on Spontaneous Arousal Patterns
and Autonomic Control in Sleeping Infants
J Pediatr. 2010 Mar 12. [Epub ahead of print]
Ritchie Centre for Baby Health Research, Monash Institute of Medical Research, Monash University, Melbourne, Victoria, Australia.
OBJECTIVE: To investigate the effects of swaddling experience on infant sleep, spontaneous arousal patterns and autonomic control. STUDY DESIGN: Twenty-seven healthy term infants, who were routinely swaddled at home (n = 15) or "naïve" to swaddling (n = 12), were monitored with daytime polysomnography in swaddled and unswaddled conditions at 3 to 4 weeks and at 3 months after birth. RESULTS: Swaddling did not alter sleep time, spontaneous arousability, or heart rate variability in routinely swaddled infants at either age. During active sleep at 3 months, cortical arousal frequency was decreased, and total sleep time was increased by swaddling in infants who were naïve to swaddling. Heart rate variability when swaddled was also highest in the naïve group. CONCLUSIONS: The effects of infant swaddling on sleep time, arousability, and autonomic control are influenced by previous swaddling experience. Infants in the naïve to swaddling group exhibited decreased spontaneous cortical arousal, similar to responses observed in future victims of sudden infant death syndrome. Infants in unfamiliar sleeping conditions may therefore be more susceptible to cardiorespiratory challenges that fail to stimulate arousal and may lead to sudden infant death syndrome. Copyright © 2010 Mosby, Inc. All rights reserved.
2. Deeg KH, Reisig A
Doppler Sonographic Screening of the Flow in the Basilar Artery
during Head Rotation Reduces the Risk for Sudden Infant Death
Ultraschall Med. 2010 Mar 16. [Epub ahead of print]
Sozialstiftung Bamberg, Klinik fA(1/4)r Kinder und Jugendliche.
PURPOSE: Position-dependent hypoperfusion of the brain stem
may be a risk factor of sudden infant death. MATERIALS AND
METHODS: From 1998 to 2009 we performed Doppler sonographic
flow measurements in the basilar artery of 18 194 newborns,
9322 boys and 8872 girls, in five different positions: the
neutral position with the head in the midline and during head
rotation to the left and right in a supine or prone position.
The peak systolic and the time average flow velocity were measured
from the flow profile. The flow velocities during head rotation
were converted to % of the flow in the neutral position. A
decrease in the velocities during head rotation below 50 %
was thought to be abnormal. Biphasic flow, flow oscillating
around the zero line or retrograde flow during rotation was
considered to be pathological. Head rotations, which had caused
abnormal and pathological flow, were avoided. The incidence
of SIDS in our study group was evaluated and compared with
the incidence in a control group of 3 519 newborns. RESULTS:
In 17 929 newborns (98.54 %) the blood flow in the basilar
artery was independent of head rotation and body position.
In 204 newborns (1.12 %) we found an abnormal decrease under
50 %. Pathological flow alterations could be found in 61 patients
(0.33 %). The overall incidence rate of SIDS in the study group
was 0.055 per thousand (1:18 194). The incidence rate of SIDS
in the control group was 1.14 per thousand (4:3519). The comparison
of both groups showed a statistically significant (p < 0.0030)
lower incidence rate in the study group. CONCLUSION: Hypoperfusion
of the brain stem may be a significant risk factor of SIDS.
© Georg Thieme Verlag KG Stuttgart · New York.
Miscarriage/Stillbirth/Prenatal Issues
1. Rådestad I, Hutti M, Säflund K, Onelöv E, Wredling R
Advice given by health-care professionals to mothers concerning
subsequent pregnancy after stillbirth
Acta Obstet Gynecol Scand. 2010 Mar 15. [Epub ahead of print]
School of Health, Care and Welfare, Mälardalen University, Eskilstuna, Sweden.
Abstract We studied the advice mothers with stillbirths were given concerning a suitable time to become pregnant. A questionnaire was sent in 2001 to mothers with a stillbirth at one of five hospitals in the Stockholm region in Sweden. At three months follow-up, 33 mothers participated and at 12 months 31. The advices varied from waiting one to 12 months. Eleven mothers were advised to trust their own feelings of readiness and six were advised to wait until they had dealt with their grief before becoming pregnant. At one year post-loss, most of the mothers felt that a suitable time for a subsequent pregnancy was as soon as the mother herself wanted. Mothers whose baby had died in utero were given radically different kinds of advice concerning a suitable time for a subsequent pregnancy. The best advice seems to be that the mother should wait until she, herself, feels ready.
2. Dadkhah F, Kashanian M, Eliasi G
A comparison between the pregnancy outcome in women both with
or without threatened abortion
Early Hum Dev. 2010 Mar 13. [Epub ahead of print]
Iran University of Medical Sciences, Department of Obstetrics & Gynecology, Iran.
OBJECTIVE: To evaluate the pregnancy outcome in pregnancies with threatened abortion (miscarriage). MATERIAL AND METHOD: A prospective cohort study was performed on 1000 pregnant women. 500 women (case group), had a history of vaginal bleeding during the first half of pregnancy and the other 500 women (control group), did not have this history. Both groups of women were monitored from 20weeks of pregnancy up to delivery. RESULTS: The women of the 2 groups did not have any significant differences according to age, parity or body mass index (BMI). Spontaneous preterm delivery [126 cases (25.2%) vs. 47 cases (9.4%), P=0.001, adj RR=1.4, CI 95%=1.2-1.5], PROM [51 cases (10.2%) vs. 24 cases (4.8%), P=0.02, adj RR=2.1, CI95%=1.2-2.3], placental abruption [20 cases (4%) vs. 7 cases (1.4%) P=0.01, adj RR=1.1, CI 95%=1.01-1.2], were more in the case group. There were no differences between the 2 groups with regard to Preeclampsia, small for gestational age (SGA), and cesarean deliveries. Neonatal weight (in term pregnancies) in the case group was lower than in the control group (3046.4+/-560.8g vs. 3317.6+/-432g, P=0.001). There was a significant relationship between the number of bleeding episodes, spontaneous preterm delivery and placental abruption and there was also a significant relationship between the amount of bleeding and placental abruption. CONCLUSION: Threatened abortion increases the rate of spontaneous preterm delivery, PROM and placental abruption, and decreases the neonatal weight. Therefore threatened abortion indicates a high risk pregnancy and, as such, demands more serious prenatal care. Copyright © 2010 Elsevier Ltd. All rights reserved.
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Loss Resource Center
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