ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1991.tb00408.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1991.tb00409.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1991.tb00410.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACTA meeting was held in Canberra on 29 and 30 July 1991 to discuss the relationship between prone sleeping position and sudden infant death syndrome (SIDS). It was sponsored by the Australian Rotary Health Research Fund in association with the Sir Robert Menzies Memorial Foundation. The catalyst for the meeting was the recent paper in theLancetreporting the results of the prospective study carried out by the Menzies Centre for Population Health Research in Hobart which reported an increased risk of SIDS for infants sleeping prone.

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1991.tb00411.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1991.tb00412.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACTThere is considerable interest in the relationship between sleeping position and the occurrence of sudden infant death syndrome (SIDS). As changes have been reported in The Netherlands in the position infants have been placed to sleep, the national Dutch sudden infant death rates were analysed over the time that such changes have taken place.The overall post‐perinatal death rate (1 week<1 year) was around 4‐4.5 per 1000 live births from 1969 until 1985. From 1985 until 1989 the rate fell from 4.1 to 2.9 per 1000 live births. During the same period the cot death/SIDS rate rose from 0.44 per 1000 in 1969 to between 1.08 and 1.31 per 1000 in 1977‐87, and subsequently fell to 0.7 per 1000 in 1989. These trends coincided with changes in prone sleeping position demonstrated in national surveys.The problems of interpreting such national data, with only 50‐60% of infant deaths being autopsied and with the possibilities of misclassification over time, are fully discussed. The data are supportive of the relationship between prone sleeping position and co

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1991.tb00413.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACTA critical overview of 19 case‐control studies that have investigated the relationship between prone sleeping position and sudden infant death syndrome (SIDS) is presented. Issues relating to the non‐comparability of the studies are described in terms of: (i) case definition; (ii) selection of controls; (iii) quality of the sleeping position data; (iv) recall bias; and (v) adjustment for confounding factors. All studies showed a positive association (2 out of the 19 studies were not significant) between prone sleeping position and SIDS. Meta‐analysis techniques applied to six of these studies, based on ‘usual’ sleeping position in cases and population representative controls, has confirmed an overall higher risk of SIDS in infants who usually sleep prone. The most common odds ratio for an association between prone sleeping position and SIDS was 2.72 (95% confidence interval 2.27‐3.26). The extent to which the methodological problems of retrospective case‐control studies interfere with our interpretations of this association

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1991.tb00414.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACTThe most recent data from the cohort and case‐control studies of SIDS and prone position recently reported from Tasmania are reviewed. The cohort analysis was based on 4103 infants born between 1 January 1988 and 1 December 1990 assessed as being at high risk at birth, of whom 29 later died of SIDS. A matched analysis which controlled for infant birthweight and maternal age indicated that prone sleeping position was associated with an increased risk of SIDS (OR 3.92, 95% Cl [1.37‐11.24]). The case‐control study was based on all (n= 55) Tasmanian SIDS deaths from October 1989 to April 1991 and matched live controls. The unadjusted odds ratio for prone position and SIDS was 5.04 (95% Cl [2.29‐11.11]). The population attributable risk percentage, based on the high risk cohort data, was 0.38 (95% Cl [0.35‐0.41]), suggesting that a significant reduction in SIDS incidence might occur if the prevalence of the prone sleeping position in the infant population were reduced. Other factors which may be important for the development of any public health interventions to reduce SIDS based on these findings are

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1991.tb00415.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACTThe rate of sudden infant death syndrome (SIDS) in Southern New Zealand has been very high with an apparent real increase in incidence from the early 1970s. Recent research is reviewed and the results of specific interventions aimed at preventing SIDS summarized. The intervention consisted of strongly advising new parents that their babies sleep on their back or side and that they avoid over‐heating, especially during infections. For the Otago area, child‐care practice has been documented and prone sleeping of 1 month old babies has declined from 41.8% in 1986 to 2.4% in 1989‐90. There is also evidence that parental control of infants' thermal environment has improved, maternal smoking during pregnancy has slightly decreased and the number of babies breast fed at 1 month of age has increased by 11%. In Southern NZ there has been a decline in post‐neonatal SIDS mortality from 6.3 deaths per 1000 live births 1979‐84 to 1.3 per 1000 live births in 1990. There are grounds for supposing that the intervention has been causative of this change, a possibility being addressed by on‐go

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1991.tb00416.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACTInvestigation of 340 babies who suffered from apparent life threatening episodes (ALTE) was performed using pneumographic studies and a variety of medical investigations. A number of medical abnormalities were demonstrated by history or investigation, including gastro‐oesophageal reflux (211), airways pathology (17), evidence of fits (25), brain‐stem tumour (2), hypoglycaemia (2), respiratory syncytial virus (8) and possible Munchausen by proxy (5). Pneumographic abnormalities were detected in 27 of the 340 infants. Home monitors were used for 135 infants. Future central apnoeas occurred in 20 of the 26 infants on home monitors that had had an abnormal pneumogram, compared with one of the 109 infants on home monitors after a normal pneumogram. Thus pneumograms have a sensitivity and specificity of 95% for predicting central apnoeas in babies who have already suffered an ALTE. The effect of eyeball pressure on the heart rate was measured in 65 babies and was found to cause a brisk drop in heart rate in 32 babies. Twenty‐two of the 32 babies had future white apnoeas (usually associated with gastro‐oesophageal reflux), compared with five of the 33 babies who had no drop in heart rate in response to eyeball pressure. Thus this test has a sensitivity of 81% and a specificity of 74% at predicting white apnoeas in babies who have already suffered

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1991.tb00417.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY