Athanasakis E, Karavasiliadou S, Styliadis I
Hippokratia. 2011 Apr;15(2):127-31.
Sudden infant death syndrome (SIDS) is defined as the sudden death of an infant under one year of age which remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene and review of the clinical history. SIDS is one of the leading causes of infant mortality and occurs from the first month, until the first year of life for newborns and infants.The aim of this review was to identify and examine risk factors responsible for causing the sudden infant death and to propose certain measures in order to protect newborns and infants from sudden death. The potential factors that contribute to the occurrence of SIDS include inadequate prenatal care, low birth weight (<2499gr), premature infants, intrauterine growth delay, short interval between pregnancies and maternal substance use (tobacco, alcohol, opiates). Moreover, factors related to infant's sleep environment such as the prone or side sleeping position and thick coverlet increase the risk of sudden death in infants. Also, the combination of risk factors such as that of prone sleeping position and soft bed mattress are linked to a 20-fold increased risk of death. Finally, polymorphisms in the serotonin transporter gene (5-HTT), viral respiratory infections, long Q-T (responsible for the presence of fatal arrhythmia) are related to the SIDS.Literature review indicates that each individual risk factor contributes to the appearance of SIDS and the establishment of certain protective measures for parents and health professionals has reduced its prevalence. But the precise identification of the SIDS causes and how these contribute to the occurrence of sudden death in neonates and infants, remains a challenge for health professionals.
婴儿猝死综合征(SIDS)的定义为:一岁以下婴儿的突然死亡,经过全面的病例调查,包括完整的尸检、死亡现场检查和临床病史回顾后,死因仍无法解释。SIDS是婴儿死亡的主要原因之一,发生于新生儿和婴儿出生后的第一个月至一岁期间。本综述的目的是识别和研究导致婴儿猝死的风险因素,并提出某些措施以保护新生儿和婴儿免于猝死。导致SIDS发生的潜在因素包括产前护理不足、低出生体重(<2499克)、早产儿、宫内生长迟缓、怀孕间隔时间短以及母亲使用药物(烟草、酒精、阿片类药物)。此外,与婴儿睡眠环境相关的因素,如俯卧或侧卧睡眠姿势以及厚重的床罩,会增加婴儿猝死的风险。而且,俯卧睡眠姿势和柔软床垫等风险因素的组合与死亡风险增加20倍有关。最后,血清素转运体基因(5-HTT)的多态性、病毒性呼吸道感染、长QT(导致致命性心律失常)与SIDS有关。文献综述表明,每个单独的风险因素都促成了SIDS的出现,为父母和健康专业人员制定某些保护措施已降低了其发生率。但准确识别SIDS的病因以及这些病因如何导致新生儿和婴儿猝死的发生,对健康专业人员来说仍然是一项挑战。