与社区对照组相比，死于婴儿猝死综合征的婴儿的症状、出汗及反应性。新西兰国家婴儿床死亡研究小组。

Symptoms, sweating and reactivity of infants who die of SIDS compared with community controls. New Zealand National Cot Death Study Group.

作者信息

Taylor B J, Williams S M, Mitchell E A, Ford R P

机构信息

Department of Paediatrics and Child Health, University of Otago Medical School, Dunedin, New Zealand.

出版信息

J Paediatr Child Health. 1996 Aug;32(4):316-22. doi: 10.1111/j.1440-1754.1996.tb02561.x.

DOI:10.1111/j.1440-1754.1996.tb02561.x

PMID:8844537

Abstract

OBJECTIVE

To describe the symptoms of illness reported by the parents of infants who have died of sudden infant death syndrome (SIDS) compared with those reported by community controls.

METHODOLOGY

A nationwide case-control study involving regions of New Zealand with 78% of all births between 1987 and 1990. Home interviews were completed with parents of 393 (81% of total) infants who died from SIDS in the post neonatal age group, and 1592 (88.4% of total) controls who were a representative sample of all hospital births in the study region.

RESULTS

Symptoms of infection were common in both cases and controls, but were not significantly different. Infants dying of SIDS, however, were likely to have symptoms suggestive of more severe illness in the 2 days before death (odds ratio [OR] = 3.02, 95% confidence interval [CI] 1.69-5.38). After adjusting for potential confounding this was still statistically significant (adjusted OR 2.36, 95% Cl 1.14-4.90). Also, babies dying of SIDS were more likely to have been less reactive to their environment in the 2 weeks before death compared with the controls (univariate OR 0.88, 95% Cl 0.55- 1.39, adjusted OR 0.55, 95% CI 0.29-0.88). 'Drenching' sweats at least weekly were reported for 15.6% of case infants compared with 5.9% of control infants (adjusted OR 2.12, 95% CI 1.53-3.39). Forty per cent of these infants had this symptom in the first 4 weeks of life when it was also associated with a significantly raised risk of SIDS. Apnoea lasting more than 20 s was reported for 13.2% of case infants compared with 5.3% of control infants (adjusted OR 1.93, 95% CI 1.17-3.17). Similarly, 71.8% of case infants' faces were reported to never turn red while awake compared to 49.8% of control infants (adjusted OR 2.98, 95% CI 2.19-4.07).

CONCLUSIONS

Only a small number (6.4%) of babies who die of SIDS have symptoms of serious illness in the 2 days before death. There is support for the hypothesis that there is a group of babies dying of SIDS who have subtle abnormalities in autonomic control or arousal ability.

摘要

目的

描述与社区对照者报告的症状相比，死于婴儿猝死综合征（SIDS）的婴儿父母所报告的疾病症状。

方法

一项全国性病例对照研究，涉及新西兰1987年至1990年间78%的出生人口所在地区。对393名（占总数的81%）在新生儿后期死于SIDS的婴儿的父母进行了家庭访谈，以及对1592名（占总数的88.4%）对照者进行了访谈，这些对照者是研究地区所有医院出生婴儿的代表性样本。

结果

感染症状在病例组和对照组中都很常见，但无显著差异。然而，死于SIDS的婴儿在死亡前2天可能有提示更严重疾病的症状（优势比[OR]=3.02，95%置信区间[CI]1.69 - 5.38）。在对潜在混杂因素进行调整后，这一差异仍具有统计学意义（调整后的OR为2.36，95%CI 1.14 - 4.90）。此外，与对照组相比，死于SIDS的婴儿在死亡前2周对环境的反应性更可能较低（单变量OR为0.88，95%CI 0.55 - 1.39，调整后的OR为0.55，95%CI 0.29 - 0.88）。报告至少每周有“大汗淋漓”症状的病例组婴儿占15.6%，而对照组婴儿为5.9%（调整后的OR为2.12，95%CI 1.53 - 3.39）。这些婴儿中有40%在出生后的前4周出现了这种症状，此时SIDS风险也显著升高。报告呼吸暂停持续超过20秒的病例组婴儿占13.2%，而对照组婴儿为5.3%（调整后的OR为1.93，95%CI 1.17 - 3.17）。同样，报告清醒时脸部从未变红的病例组婴儿占71.8%，而对照组婴儿为49.8%（调整后的OR为2.98，95%CI 2.19 - 4.07）。