Department of Paediatrics, Monash University, Melbourne, Australia.
University Hospital Montpellier, France.
Sleep Med Rev. 2024 Dec;78:101990. doi: 10.1016/j.smrv.2024.101990. Epub 2024 Jul 31.
Approximately 15 million babies are born preterm (<37 weeks of completed gestation) worldwide annually. Although neonatal and perinatal medicine have contributed to the increased survival rate of preterm newborn infants, premature infants are at increased risk of mortality in the first years of life. Infants born preterm are at four times the risk of Sudden Infant Death Syndrome (SIDS) compared to infants born at term. SIDS is believed to be multifactorial in origin. The Triple Risk hypothesis has been proposed to explain this. The model suggests that when a vulnerable infant, such as one born preterm, is at a critical but unstable developmental period in homeostatic control, death may occur if exposed to an exogenous stressor, such as being placed prone for sleep. The highest risk period is at ages 2-4 months, with 90 % of deaths occurring before 6 months. The final pathway to SIDS is widely believed to involve some combination of immature cardiorespiratory control and a failure of arousal from sleep. This review will focus on the physiological factors which increase the risk for SIDS in preterm infants and how these factors may be identified and potentially lead to effective preventative strategies.
全世界每年大约有 1500 万婴儿早产（<37 周妊娠）。尽管新生儿和围生医学有助于提高早产儿的存活率，但早产儿在生命的头几年仍有更高的死亡风险。与足月出生的婴儿相比，早产儿患婴儿猝死综合征（SIDS）的风险高 4 倍。SIDS 被认为是多因素起源的。三重风险假说被提出以解释这一点。该模型表明，当一个脆弱的婴儿，如早产儿，处于体内平衡控制的关键但不稳定的发育阶段时，如果暴露于外部应激源，如俯卧睡眠，可能会导致死亡。风险最高的时期是 2-4 个月大，90%的死亡发生在 6 个月前。广泛认为 SIDS 的最终途径涉及不成熟的心肺控制和睡眠唤醒失败的某种组合。这篇综述将重点讨论增加早产儿患 SIDS 风险的生理因素，以及如何识别这些因素，并可能导致有效的预防策略。
