Department of Child and Adolescent Medicine, CHU de Rennes, Rennes, France.
CHU Rennes, Inserm, CIC 1414 (Clinical Investigation Center), F-35000 Rennes, France.
Arch Pediatr. 2024 Apr;31(3):195-201. doi: 10.1016/j.arcped.2023.12.003. Epub 2024 Mar 27.
Prematurity is one of the risk factors for sudden unexpected infant death (SUID), a phenomenon that remains poorly explained.
The analysis of specific factors associated with SUID among very premature infants (VPI) was performed through a retrospective review of data collected in the French SUID registry from May 2015 to December 2018. The factors associated with SUID among VPI were compared with those observed among full-term infants (FTI). Results are expressed as means (standard deviation [SD]) or medians (interquartile range [IQR)].
During the study period, 719 cases of SUID were included in the registry, 36 (incidence: 0.60 ‰) of which involved VPI (gestational age: 29.2 [2] weeks, 1157 [364]) g] and 313 (0.18 ‰) involved FTI (gestational age: 40 [0.8] weeks, 3298 [452] g). The infants' postnatal age at the time of death was similar in the two groups: 15.5 (12.2-21.8) vs. 14.5 (7.1-23.4) weeks. We observed low breastfeeding rates and a high proportion of fathers with no occupation or unemployment status among the VPI compared to the FTI group (31% vs. 55 %, p = 0.01 and 32% vs. 13 %, p = 0.05, respectively). Among the VPI, only 52 % were in supine position, and 29 % were lying prone at the time of the SUID (compared to 63 % and 17 %, respectively, in the FTI group).
This study confirms prematurity as a risk factor for SUID with no difference in the SUID-specific risk factors studied except for breastfeeding and socioeconomic status of the fathers. VPI and FTI died at similar chronological ages with a high proportion of infants dying in prone position. These results argue for reinforcement of prevention strategies in cases of prematurity.
早产是婴儿猝死综合征（SUID）的一个风险因素，这一现象仍未得到很好的解释。
通过对 2015 年 5 月至 2018 年 12 月期间法国 SUID 登记处收集的数据进行回顾性分析，研究了与极早产儿（VPI）SUID 相关的特定因素。将 VPI 中与 SUID 相关的因素与足月婴儿（FTI）中的因素进行了比较。结果以平均值（标准差[SD]）或中位数（四分位距[IQR]）表示。
在研究期间，登记处共纳入 719 例 SUID 病例，其中 36 例（发生率：0.60‰）为 VPI（胎龄：29.2[2]周，1157[364]g），313 例（0.18‰）为 FTI（胎龄：40[0.8]周，3298[452]g）。两组婴儿死亡时的生后年龄相似：15.5（12.2-21.8）与 14.5（7.1-23.4）周。与 FTI 组相比，VPI 组的母乳喂养率较低，父亲无职业或失业的比例较高（分别为 31%与 55%，p=0.01 和 32%与 13%，p=0.05）。在 VPI 中，只有 52%的婴儿处于仰卧位，29%的婴儿在 SUID 时处于俯卧位（而 FTI 组分别为 63%和 17%）。
这项研究证实，早产是 SUID 的一个危险因素，除了母乳喂养和父亲的社会经济地位外，研究中没有发现 SUID 特定危险因素的差异。VPI 和 FTI 在相似的年龄死亡，大部分婴儿死于俯卧位。这些结果表明，在早产儿中应加强预防策略。
