NSIDRC Journal Article Alert — April 23, 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. Release of erythroblasts to the peripheral blood suggests
higher exposure to hypoxia in cases of SIDS with co-sleeping
compared to SIDS non-co-sleeping
Cohen MC, Yong CY, Evans C, Hinchliffe R, Zapata-Vazquez RE
Forensic Sci Int. 2010 Apr 15;197(1-3):54-8. Epub 2010 Jan
13
Sheffield Children's Hospital NHS Foundation Trust, Histopathology Department, Western Bank, Sheffield, Yorkshire, UK. Marta.Cohen@sch.nhs.uk
Sudden unexpected death in infancy (SUDI) includes sudden infant death syndrome (SIDS). Co-sleeping is regarded as a major risk factor for SIDS. Under normal circumstances, nucleated red blood cells (nRBCs) are absent from the peripheral blood and their release can occur in cases with a probable hypoxic mode of death. The aim of our study was to assess the significance of the release of nRBCs in SIDS occurring during co-sleeping and the association with hemorrhages in the dura and the lungs. 35 cases were retrospectively assigned to one of the following categories: (I) 9 SUDI (of various causes) with no co-sleeping; (II) 16 SIDS while co-sleeping; (III) cause of death in hypoxic circumstances (3 hangings, 2 cardiac malformations, 1 meningitis 1 intoxication with diazepam); (IV) 3 SIDS in the cot. nRBCs were present in 5/9 cases of Category I (mean: 0.5%); 10/16 cases of Category II (mean: 1.87%); 7/7 cases of Category III (mean: 3.8%) and 0/3 cases of Category IV (mean: 0). ANOVA one-way test showed a significance of 0.003 amongst the 4 groups. The presence of diffuse intra-alveolar hemorrhage was associated with a higher release of nRBCs (mean: 3.1%) than focal hemorrhage (mean 0.6%). nRBCs were associated with focal hemorrhages in the falx and tentorium (mean: 2.3 vs. 0.9% when no hemorrhages were seen). The high mean of nRBCs seen in the co-sleeping SIDS cases suggests a higher exposure to hypoxia in the co-sleeping group which may have led to the release of nRBCs. More cases need to be analyzed to confirm this hypothesis. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.
2. The role of CO(2) and central chemoreception in the control
of breathing in the fetus and the neonate
Darnall RA
Respir Physiol Neurobiol. 2010 Apr 15. [Epub ahead of print]
Departments of Physiology and Neurobiology and Pediatrics, Dartmouth Medical School, 1 Medical Center Drive, Lebanon, NH 03756.
Central chemoreception is active early in development and
likely drives fetal breathing movements, which are influenced
by a combination of behavioral state and powerful inhibition.
In the premature human infant and newborn rat ventilation increases
in response to CO(2); in the rat the sensitivity of the response
increases steadily after approximately P12. The premature human
infant is more vulnerable to instability than the newborn rat
and exhibits periodic breathing that is augmented by hypoxia
and eliminated by breathing oxygen or CO(2) or the administration
of respiratory stimulants. The sites of central chemoreception
active in the fetus are not known, but may involve the parafacial
respiratory group which may be a precursor to the adult RTN.
The fetal and neonatal rat brainstem spinal-cord preparations
promise to provide important information about central chemoreception
in the developing rodent and will increase our understanding
of important clinical problems, including The Sudden Infant
Death Syndrome, Congenital Central Hypoventilation Syndrome,
and periodic breathing and apnea of prematurity. Copyright
© 2010. Published by Elsevier B.V.
Other Infant Death
1. Neonatologists urge national plan to improve infant mortality
rates
Eggertson L
CMAJ. 2010 Apr 20;182(7):E277-8. Epub 2010 Mar 15.
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