Sudden infant death syndrome in Brazil
fact or fancy?
Keywords:
Sudden infant death, Infant mortality, Autopsy, Incidence, DiagnosisAbstract
CONTEXT AND OBJECTIVE: The true incidence of sudden infant death syndrome (SIDS) in Brazil is unknown. The aim here was to identify SIDS cases in the city of Ribeirão Preto, State of São Paulo, between 2000 and 2005, in order to estimate its incidence. DESIGN AND SETTING: Retrospective analysis of data on live births and infant deaths in Ribeirão Preto and from autopsies of infants performed at the Death Verification Service of the Interior (SVOI) between 2000 and 2005. RESULTS: There were 47,356 live births and 537 deaths, with infant mortality rates ranging from 12.9‰ to 10.9‰ of live births. Among the 24 infants who died possibly due to SIDS and who were autopsied at the SVOI, six were from families living in the municipality (0.13‰ of live births): three (50%) were diagnosed as SIDS, and one each (16.66%) as indeterminate cause, bronchoaspiration and cerebral edema. Two deaths occurred in the first month of life (33.33%) and one each (16.66%) at two, four, six and eight months. Two deaths each (33.33%) occurred in the months of February and December, one each in August and October (16.66%). Four cases (66.7%) occurred in the summer and one each (16.66%) in winter and spring. There was 5:1 predominance of males over females. CONCLUSIONS: The frequency of SIDS was lower than what has been reported worldwide and in the Brazilian literature, thus suggesting underdiagnosis, indicating the lack of any specific postmortem protocol for SIDS identification and showing the need to implement this.
Downloads
References
Bergman AB, Beckwith JB, Ray CG. Sudden infant death syndrome: proceedings of the second international conference on causes of sudden death in infants. Seattle: University of Washington Press; 1970.
Zylke JW. Sudden infant death syndrome: resurgent research offers hope. JAMA. 1989;262(12):1565-6.
Willinger M, James LS, Catz C. Defining the sudden infant death syndrome (SIDS): deliberations of an expert panel convened by the National Institute of Child Health and Human Development. Pediatr Pathol. 1991;11(5):677-84.
Fleming PJ, Gilbert R, Azaz Y, et al. Interaction between bedding and sleeping position in the sudden infant death syndrome: a population based case-control study. BMJ. 1990;301(6743):85-9.
Wigfield RE, Fleming PJ, Berry PJ, Rudd PT, Golding J. Can the fall in Avons sudden infant death rate be explained by changes in sleeping position? BMJ. 1992;304(6822):282-3.
Markestad T, Skadberg B, Hordvik E, Morild I, Irgens LM. Sleeping position and sudden infant death syndrome (SIDS): effect of an intervention programme to avoid prone sleeping. Acta Paediatr. 1995;84(4):375-8.
Engelberts AC, de Jonge GA, Kostense PJ. An analysis of trends in the incidence of sudden infant death in The Netherlands 1969-89. J Paediatr Child Health. 1991;27(6):329-33.
Spiers PS, Guntheroth WG. Recommendations to avoid the prone sleeping position and recent statistics for sudden infant death syndrome in the United States. Arch Pediatr Adolesc Med. 1994;148(2):141-6.
Beal SM. Sudden infant death syndrome (SIDS) in South Australia related to sleeping conditions. Med J Aust. 1993;158(10):723.
Waters KA, Gonzalez A, Jean C, Morielli A, Brouillette RT. Face-straight-down and face-near-straight-down positions in healthy, prone-sleeping infants. J Pediatr. 1996;128(5 Pt 1):616-25.
Dwyer T, Ponsonby AL. The decline of SIDS: a success story for epidemiology. Epidemiology. 1996;7(3):323-5.
Valdes DaPena M, Naeye RL, Gilbert Barness E. Sudden infant death syndrome. In: Gilbert Barness EF, editor. Potters pathology of the fetus and infant. St Louis: Mosby; 1997. p. 433-9.
Hunt CE, Hauck FR. Sudden infant death syndrome. CMAJ. 2006;174(13):1861-9.
Landi K, Gutierrez C, Sampson B, et al. Investigation of the sudden death of infants: a multicenter analysis. Pediatr Dev Pathol. 2005;8(6):630-8.
Nelson EA, Taylor BJ. International Child Care Practices Study: infant sleep position and parental smoking. Early Hum Dev. 2001;64(1):7-20.
Victora CG, Nobre LC, Lombardi C, et al. Quadro epidemiológico das mortes súbitas na infância em cidades gaúchas (Brasil). [Epidemiologic picture of sudden infant death in cities of Rio Grande do Sul (Brazil)]. Rev Saude Publica. 1987;21(6):490-6.
Peres LC. Sudden unexpected infant death syndrome in Ribeirão Preto, Brazil. Sao Paulo Med J. 1998;116(5):1803-07.
Nunes ML, Martins MP, Nelson EA, Cowan S, Cafferata ML, Costa JC. Orientações adotadas nas maternidades dos hospitais-escola do Brasil, sobre a posição de dormir. [Instructions from teaching hospital maternity wards to parents concerning the sleeping position of newborns]. Cad Saúde Pública = Rep Public Health. 2002;18(3):883-6.
Geib LTC, Nunes ML. Hábitos de sono relacionados à síndrome da morte súbita do lactente: estudo populacional. [Sleeping habits related to sudden infant death syndrome: a population-based study]. Cad Saúde Pública = Rep Public Health. 2006;22(2):415-23.
Geib LTC, Nunes ML. The incidence of sudden death syndrome in a cohort of infants. J Pediatr (Rio J). 2006;82(1):21-6.
Beal S, Porter C. Sudden infant death syndrome related to climate. Acta Paediatr Scand. 1991;80(3):278-87.
Templeman C. Two hundred and fifty-eight cases of suffocation of infants. Med Chir Soc (Edinburgh) 1892;6:322-9.
Brooke H, Gibson A, Tappin D, Brown H. Case-control study of sudden infant death syndrome in Scotland, 1992-5. BMJ. 1997;314(7093):1516-20.
Krous HF, Beckwith JB, Byard RW, et al. Sudden infant death syndrome and unclassified sudden infant deaths: a definitional and diagnostic approach. Pediatrics. 2004;114(1):234-8.
Centers for Disease Control and Prevention (CDC). Guidelines for death scene investigation of sudden, unexplained infant deaths: recommendations of the interagency panel on sudden infant death synd. MMWR Recomm Rep. 1996;45(RR-10):1-6. Available from: http://www.cdc.gov/mmwR/preview/mmwrhtml/00042657.htm Accessed in 2007 (Nov 27).
Peres LC. SIDS-Síndrome infantil da defunção súbita. [SIDS-Sudden infant death syndrome]. Medicina (Ribeirão Preto). 2005;38(1):34-41.