Data were collected retrospectively on
733 infants identified to be at high risk, epidemiologically, for
SIDS: siblings of SIDS victims (SibSIDS, n=215), infants who
experienced an apparent life threatening event (ALTE) at home (ALTE
n=237), and premature infants with histories of apnea or bradycardia
in the newborn nursery (Premie Apnea, n=281). The objectives of this
study were to determine the prevalence of at least one episode of
prolonged central apnea in each group, to assess whether the
prevalence of central apnea differed by group and other risk
factors, and to evaluate the temporal interval of monitoring before
an infant's initial episode of central apnea.
The following data on central apnea
prevalence were presented at the 5th Sudden Infant Death Syndrome
International Conference in Rouen, France, 1998:
| | | Group | |
| Duration
(s) | ALTE | SibSIDS | Premie
Apnea |
| 15 | 25.3% | 21.4% | 29.7%* |
| 18 | 4.1% | 6.1% | 14.5%* |
| 20 | 3.0% | 3.1% | 8.5%* |
| PA-15** | 6.4% | 5.3% | 16.4%* |
| PA-18** | 3.0% | 3.1% | 12.1%* |
* p < 0.05
** Defined as apnea at least 15 seconds
(PA-15) in duration or 18 seconds (PA-18) in durationwhen associated
with bradycardia at least 5 seconds in duration.
The Prevalence and
Determinants of Prolonged Bradycardia in High Risk SIDS
Infants
The objective of this retrospective
descriptive study was to estimate the prevalence of bradycardia of
varying durations among three groups of infants known to be at
increased epidemiologic risk for SIDS: siblings of SIDS victims
(SibSIDS, n=215), infants who experienced an apparent life
threatening event (ALTE) at home (ALTE n=237), and premature infants
with histories of apnea or bradycardia in the newborn nursery
(Premie Apnea, n=281).
The following data on bradycardia
prevalence were presented at the 8th European Society for the Study
and Prevention of Infant Death Conference in Jerusalem, Israel,
1999:
| | | Group | |
| Duration
(s) | ALTE | SibSIDS | Premie
Apnea |
| 5 | 35.0% | 30.3% | 73.0%* |
| 10 | 20.5% | 11.9% | 54.9%* |
| 15 | 4.6% | 4.2% | 29.8%* |
* p < 0.05
Prolonged Apnea and Prolonged Bradycardia Following DTP
Immunization in Preterm Infants: A Multicenter
Study
The American SIDS Institute is
coordinating a multicenter research study on 200 premature infants
(younger than 37 weeks gestation) in which several neonatal centers
around the country are participating. This study is a randomized
controlled clinical trial that will examine the relationship between
diphtheria-tetanus-acellular pertussis immunization and the
occurrence of prolonged apnea and bradycardia in preterm
infants.
The following investigators and
corresponding neonatal centers are participating in this
project:
Tracy Carbone, MD, Principal Investigator
The Valley Hospital
Pediatric Sleep Disorders Program
Ridgewood, New Jersey | Larry Consenstein, MD
St. Joseph's Hospital Health Center
Department of Pediatrics
Syracuse, New York |
Joseph Hageman, MD
Evanston Hospital
Sleep
Disorders Center
Evanston,
Illinois | Nilima Karamchandani, MD
Western Pennsylvania Hospital
Infant Apnea Center
Pittsburgh, Pennsylvania |
Harel Rosen, MD
UMDNJ-RWJMS
Department of
Neonatology
New Brunswick, New
Jersey | Kimon Violaris, MD
The
Brooklyn Hospital Center
Apnea
Center
Brooklyn, New
York |
Identification of Infants at Risk: Clinical,
Epidemiologic, and Chemical
Factors
We are examining a variety of factors
for their potential associations with SIDS and related risks.
Programs are in place to examine various data including
physiological characteristics and plasma catecholamine levels in
order to identify subtle chronic abnormalities that may place
infants at increased risk for sudden death.