2011年1月20日 星期四

Sudden Infant Death Syndrome



Sudden Infant Death Syndrome (SIDS)
N Engl J Med 2009; 361:795-805


Definition
Sudden death of an infant or young child, which is unexpected by history, and in which a thorough post mortem examination fails to demonstrate an adequate cause of death.
Triple-Risk Model of SIDS

1. Intrinsic risk factors
  • Genetic
  • Male sex
  • Polymorphism in the gene encoding the promoter region of the serotonin transporter
  • Black or Native American race or ethnic group
  • Developmental
  • Prematurity
  • Environmental
  • Perinatal exposure to smoking
  • Parental smoking, ethanol intake, or drug use
  • Socio-economic disadvantage
2. Extrinsic risk factors
  • Sleeping on the side or in prone position
  • Soft bedding
  • Bed sharing
  • Mild infections, including colds
5 Steps in the Putative Terminal Respiratory Pathway Associated with SIDS

Recommendations for Risk Reduction and Counseling
  • Putting infants to bed in the supine position on a firm mattress, preferably with a pacifier and in a shared room (but in a separate bed).
  • Prone and side sleeping, overheating, bed sharing, soft bedding, and smoking by mothers during pregnancy or around infants should be avoided.
  • Home cardio-respiratory monitoring of apnea and bradycardia is not recommended because it has not been shown to prevent SIDS.
Safe sleeping positions
Safe clothes and bedding
Safe sleeping dos and don'ts

嬰兒猝死 (sudden infant death syndrome) 的危險因子,下列敘述何者錯誤?【96急專】
(A)早產
(B)母親抽菸
(C)父母親低社經地位,教育水準低
(D)冬天易發生
(E)高齡母親    X
 急診醫學科專科醫師甄審筆試試

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