Book contents
- Frontmatter
- Contents
- Dedication
- Acknowledgements
- Foreword
- 1 Sudden Infant Death Syndrome: Definitions
- 2 Sudden Infant Death Syndrome: An Overview
- 3 Sudden Unexplained Death in Childhood: An Overview
- 4 Sudden Infant Death Syndrome: History
- 5 Responding to Unexpected Child Deaths
- 6 The Role of Death Review Committees
- 7 Parental Perspectives
- 8 Parental Grief
- 9 Promoting Evidence-Based Public Health Recommendations to Support Reductions in Infant and Child Mortality: The Role of National Scientific Advisory Groups
- 10 Risk Factors and Theories
- 11 Shared Sleeping Surfaces and Dangerous Sleeping Environments
- 12 Preventive Strategies for Sudden Infant Death Syndrome
- 13 The Epidemiology of Sudden Infant Death Syndrome and Sudden Unexpected Infant Deaths: Diagnostic Shift and other Temporal Changes
- 14 Future Directions in Sudden Unexpected Death in Infancy Research
- 15 Observational Investigations from England: The CESDI and SWISS Studies
- 16 An Australian Perspective
- 17 A South African Perspective
- 18 A United Kingdom Perspective
- 19 A United States Perspective
- 20 A Scandinavian Perspective
- 21 Neonatal Monitoring: Prediction of Autonomic Regulation at 1 Month from Newborn Assessments
- 22 Autonomic Cardiorespiratory Physiology and Arousal of the Fetus and Infant
- 23 The Role of the Upper Airway in SIDS and Sudden Unexpected Infant Deaths and the Importance of External Airway-Protective Behaviors
- 24 The Autopsy and Pathology of Sudden Infant Death Syndrome
- 25 Natural Diseases Causing Sudden Death in Infancy and Early Childhood
- 26 Brainstem Neuropathology in Sudden Infant Death Syndrome
- 27 Sudden Infant Death Syndrome, Sleep, and the Physiology and Pathophysiology of the Respiratory Network
- 28 Neuropathology of Sudden Infant Death Syndrome: Hypothalamus
- 29 Abnormalities of the Hippocampus in Sudden and Unexpected Death in Early Life
- 30 Cytokines, Infection, and Immunity
- 31 The Genetics of Sudden Infant Death Syndrome
- 32 Biomarkers of Sudden Infant Death Syndrome (SIDS) Risk and SIDS Death
- 33 Animal Models: Illuminating the Pathogenesis of Sudden Infant Death Syndrome
33 - Animal Models: Illuminating the Pathogenesis of Sudden Infant Death Syndrome
Published online by Cambridge University Press: 20 July 2018
- Frontmatter
- Contents
- Dedication
- Acknowledgements
- Foreword
- 1 Sudden Infant Death Syndrome: Definitions
- 2 Sudden Infant Death Syndrome: An Overview
- 3 Sudden Unexplained Death in Childhood: An Overview
- 4 Sudden Infant Death Syndrome: History
- 5 Responding to Unexpected Child Deaths
- 6 The Role of Death Review Committees
- 7 Parental Perspectives
- 8 Parental Grief
- 9 Promoting Evidence-Based Public Health Recommendations to Support Reductions in Infant and Child Mortality: The Role of National Scientific Advisory Groups
- 10 Risk Factors and Theories
- 11 Shared Sleeping Surfaces and Dangerous Sleeping Environments
- 12 Preventive Strategies for Sudden Infant Death Syndrome
- 13 The Epidemiology of Sudden Infant Death Syndrome and Sudden Unexpected Infant Deaths: Diagnostic Shift and other Temporal Changes
- 14 Future Directions in Sudden Unexpected Death in Infancy Research
- 15 Observational Investigations from England: The CESDI and SWISS Studies
- 16 An Australian Perspective
- 17 A South African Perspective
- 18 A United Kingdom Perspective
- 19 A United States Perspective
- 20 A Scandinavian Perspective
- 21 Neonatal Monitoring: Prediction of Autonomic Regulation at 1 Month from Newborn Assessments
- 22 Autonomic Cardiorespiratory Physiology and Arousal of the Fetus and Infant
- 23 The Role of the Upper Airway in SIDS and Sudden Unexpected Infant Deaths and the Importance of External Airway-Protective Behaviors
- 24 The Autopsy and Pathology of Sudden Infant Death Syndrome
- 25 Natural Diseases Causing Sudden Death in Infancy and Early Childhood
- 26 Brainstem Neuropathology in Sudden Infant Death Syndrome
- 27 Sudden Infant Death Syndrome, Sleep, and the Physiology and Pathophysiology of the Respiratory Network
- 28 Neuropathology of Sudden Infant Death Syndrome: Hypothalamus
- 29 Abnormalities of the Hippocampus in Sudden and Unexpected Death in Early Life
- 30 Cytokines, Infection, and Immunity
- 31 The Genetics of Sudden Infant Death Syndrome
- 32 Biomarkers of Sudden Infant Death Syndrome (SIDS) Risk and SIDS Death
- 33 Animal Models: Illuminating the Pathogenesis of Sudden Infant Death Syndrome
Summary
Introduction
Three research areas derived from human studies of epidemiology, pathology, and sleep in infants have made contributions to our understanding of sudden infant death syndrome (SIDS). Epidemiological studies of infants who died of SIDS have identified a variety of risk factors associated with increased and decreased risk of SIDS (1-7), including prone sleeping position (8, 9), maternal cigarette smoking during pregnancy, and heat stress in the infant, often related to overheated environments, excessive bed clothing, or other unsafe sleeping practices (8, 10, 11). Additional risk factors include a recent upper respiratory tract infection, bed sharing, prematurity, and intrauterine and/or postnatal hypoxic stress.
Similar progress in understanding the origins of SIDS has been made by pathologists analysing the brains of infants who died and were classified as SIDS. Analyses of brain tissue from these infants have consistently revealed a high prevalence of abnormalities in the brainstem serotoninergic system including an increased number of serotonergic neurons, a higher proportion of serotonergic neurons displaying immature morphology, decreased tissue levels of serotonin (5-HT) and its synthetic enzyme, tryptophan hydroxylase 2 (TPH2), and decreased 5-HT receptor binding intensity both in serotonergic nuclei themselves and in several nuclei that are important in cardiorespiratory control (9, 12-16). Similar serotonin system deficits have been described in infants who died of asphyxia (17). There has been persistent speculation that infants who died of SIDS suffered from hypoxia (i.e. low oxygen levels) at some time preceding death (18-22), and hypoxia appeared to delay maturation of the brain in infants who died of SIDS (19-21, 23, 24).
Finally, sleep studies in the infants who subsequently died of SIDS have revealed a sequence of repetitive episodes of hypoxia preceding, or following, apnea and/or bradycardia, followed by autoresuscitative efforts to restore normal breathing and arouse from sleep (25-28). Death occurred when the autoresuscitation or arousal following prolonged apnea failed to restore regular breathing and adequate oxygenation. Many infants experienced sequences of multiple hypoxic apneic events from which they recovered, only to succumb to a final event in which autoresuscitation and/or arousal failed.
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- SIDS Sudden Infant and Early Childhood DeathThe past, the present and the future, pp. 759 - 828Publisher: The University of Adelaide PressPrint publication year: 2018