Möllborg Per, Wennergren Göran, Almqvist Petra, Alm Bernt
Department of Paediatrics, University of Gothenburg, Queen Silvia Children's Hospital, Gothenburg, Sweden.
Department of Forensic Medicine, National Board of Forensic Medicine, Stockholm, Sweden.
Acta Paediatr. 2015 Aug;104(8):777-83. doi: 10.1111/apa.13021. Epub 2015 May 8.
Despite its declining incidence, sudden infant death syndrome (SIDS) is still an important cause of death in infancy. This study investigated the environmental circumstances associated with SIDS, by analysing data from all sudden unexpected deaths in infancy (SUDI) in Sweden from 2005 to 2011.
All Swedish infants forensically autopsied up to the age of 365 days from 2005 to 2011 were included. Medical records were obtained from the hospitals and supplementary data from the Swedish Medical Birth Register.
Of the 261 infants, 136 were defined as SIDS and 125 as explained SUDI. The documentation in the medical records was poor when it came to issues such as bed sharing, sleep position, smoking, breastfeeding and pacifier use. The main findings were a significantly higher prevalence of bed sharing in SIDS than in explained deaths (odds ratio 7.77, 95% confidence interval 2.36-25.57) and that prone sleeping was still overrepresented. Bronchopneumonia, other infections and congenital anomalies were the most common causes of explained SUDI.
Bed sharing and prone sleeping were more common in SIDS than in explained SUDI. Sparse data in medical records were a problem, and the authors are now working with the National Board of Health and Welfare on a project to establish new routines.
尽管婴儿猝死综合征(SIDS)的发病率在下降,但它仍是婴儿期重要的死亡原因。本研究通过分析2005年至2011年瑞典所有婴儿意外猝死(SUDI)的数据,调查与SIDS相关的环境情况。
纳入2005年至2011年期间接受法医尸检的所有365日龄以内的瑞典婴儿。从医院获取病历,并从瑞典医学出生登记处获取补充数据。
在261名婴儿中,136名被定义为SIDS,125名被定义为原因明确的SUDI。在同床睡眠、睡眠姿势、吸烟、母乳喂养和使用安抚奶嘴等问题上,病历记录较差。主要发现是,SIDS中同床睡眠的发生率显著高于原因明确的死亡(优势比7.77,95%置信区间2.36 - 25.57),且俯卧睡眠的比例仍然过高。支气管肺炎、其他感染和先天性异常是原因明确的SUDI最常见的原因。
与原因明确的SUDI相比,SIDS中同床睡眠和俯卧睡眠更为常见。病历数据稀少是一个问题,作者目前正在与国家卫生和福利委员会合作开展一个项目,以建立新的常规做法。