MINISTRY OF HEALTH OF UKRAINELUGANSK STATE MEDICAL UNIVERSITY

DEPARTMENT OF PEDIATRICSREPORT PRESENTED BY RUBEN

GOMBALANDI .SUPERVISED BY ASST.PROF. OKSANA

BABINOVA. ON

Lool at this cute being!!!!!

The next morning ,you find this!!!!!!!!!!!!!!!!!!

INTRODUCTION

Sudden infant death syndrome continues to be the most common cause of post neonatal death, account for 25% of all death between 1month of age and 1 year of Age.SIDS Goes , by different names ‘’COT Death , Cribs.Some environmental risk factors are modifiable

Reducing exposure to modifiable risk factors has lowered the incidence of SIDS

New research indicates genetic risk factors Actual risk of SIDS may depend on interaction of environmental and genetic risk factors

DEFINITIONSudden Infant Death Syndrome (SIDS) is a medical term that describes the sudden death of an infant which remains unexplained after all known and possible causes have been carefully ruled out through autopsy, death scene investigation, and review of the medical history

EPIDEMIOLOGY

SIDS is responsible for more deaths than any other cause in childhood for babies one month to one year of age, claiming - 7,000 babies each year -nearly one baby every hour of every day

EPIDEMIOLOGICAL FACTS

Strikes families of all races, ethnic and socioeconomic origins without warning; neither parent nor physician can predict that something is going wrong. In fact, most SIDS victims appear healthy prior to death

DEMOGRAPHY

1.Sids is less frequent in the 1st month of life

2.Peak month of occurance is between 2-4 month

3.Boys are more likely to be affected than girls

4.Low socioeconomic stance enhances SIDS Occurance

What Causes SIDS?No adequate medical explanations for SIDS

deaths, current theories include: *Tobacco, cocaine and heroin use by mothers during pregnancy

puts the infant at a higher risk for SIDS.*Infants who sleep on their sides and stomachs have a higher risk

of SIDS than babies who sleep on their backs. (Remember to lay the baby BACK to bed)

*Babies born to teenage mothers have a higher risk of SIDS than babies who are born to older mothers.

PATHOPHYSIOLOGY

Multifactorial in origin

Triple Risk HypothesisVulnerable infantCritical developmental period in homeostatic controlExogenous stressors

Final pathway believed to involve immature cardiorespiratory and autonomic control along with failure of arousal responsiveness from sleep

SIDS FINDINGSExternal Appearance:*Normal state of hydration & nutrition*Normal state of hydration & nutrition*Small amount of frothy fluid in or about mouth & nose*Small amount of frothy fluid in or about mouth & nose*Vomitus present*Vomitus present*Postmortem lividity &/or rigors*Postmortem lividity &/or rigors*Livormortis *Livormortis *Disfiguration/Unusual position - dependant blood pooling/pressure *Disfiguration/Unusual position - dependant blood pooling/pressure marksmarks

Internal Appearances On Autopsy:Pulmonary congestion & edemaIntrathoracic petechiae 90% of timeStomach contents in trachea

RISKS FACTORS DIVIDED INTO:

SOCIAL FACTORS

Increased risk with:Lower socioeconomic statusYounger maternal ageLower maternal education

MOTHER RELATED FACTORSMothers of SIDS infants:

Less prenatal careLow birth weightPreterm birthIUGRShorter intervals between pregnancies (< 18 mo)

SMOKING

OVER HEATING

PRONE SLEEPING

WHEN THE CHILD IS IN PRONE POSITION

SUBSTANCE USE AS A PREDISPOSING FACTOR

GENETICS RISK FACTORS

Sodium and Potassium channel polymorphisms associated with long QT syndrome

Polymorphisms in serotonin transporter (5-HTT) gene

DIAGNOSIS

By definition, SIDS is a diagnosis of exclusion declaration of Sids is made after: Complete autopsy, Investigation of child’s death scene.

RISK REDUCTION

POSSIBLE MEASURES TO BE TAKEN INCLUDE:

BACK TO SLEEP IS PARAMOUNT

HARD Surface

Sleeping clothes

PROTECTIVE GUARD

DO NOT SMOKE DURING PREGNANCY AND AROUND THE INFANT

AVIOD OVERHEATING THE BABY’S SURROUNDING

BREAST FEED THE INFANT

GET A SEPARATE BED FOR THE INFANT

CONCLUSIONSSIDS is:

Major cause of death in infants after 1st Major cause of death in infants after 1st month of lifemonth of life

Sudden & silent in an apparently healthy Sudden & silent in an apparently healthy infantinfant

Unpredictable & unpreventableUnpredictable & unpreventable Quick death with no signs of suffering - Quick death with no signs of suffering -

usually during sleepusually during sleep

REFERENCE Hunt CE, Hauck FR. Sudden infant death syndrome. Cmaj. Jun 20 2006;174(13):1861-1869.Moon RY, Horne RS, Hauck FR. Sudden infant death syndrome. Lancet. Nov 3 2007;370(9598):1578-1587.Weese-Mayer DE, Ackerman MJ, Marazita ML, Berry-Kravis EM. Sudden Infant Death Syndrome: review of implicated genetic factors. Am J Med Genet A. Apr 15 2007;143A(8):771-788.Gurbutt D, Gurbutt R. Risk reduction and sudden infant death syndrome. Community Pract. Jan 2007;80(1):24-27.Fleming P, Blair PS. Sudden Infant Death Syndrome and parental smoking. Early Hum Dev. Nov 2007;83(11):721-725.Damato EG. Safe sleep: can pacifiers reduce SIDS risk? Nurs Womens Health. Feb 2007;11(1):72-76.

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