New research provides clues as to why some babies die of SIDS

Australian scientists have found that some infants at risk for sudden infant death syndrome (SIDS) have low levels of an enzyme called butyrylcholinesterase (BChE) in their blood.Their study was published in the journal on May 6th. eBioMedicineIf the results are supported by further research, it can pave the way for newborn screening and intervention.

Dr. Carmel Harrington, who led the study at the Westmead Children’s Hospital in Sydney, Australia, said:

Researchers have been trying to scrape the biological basis of mysterious syndromes for decades. Although public health campaigns have significantly reduced the incidence of SIDS, they are the leading cause of sudden infant deaths under the age of one in Western countries. In the United States, about 3,400 babies die suddenly and suddenly each year. Centers for Disease Control and Prevention.. This includes infants who die suddenly from known causes such as choking, and infants who die without a clear cause such as SIDS. Almost half of cases of sudden infant death (SUID) in the United States are due to SIDS.

What new research found

One of the reasons SIDS remains so tragic and mysterious is that SIDS was not caused by a single biological mechanism. Combination of factors Dr. Thomas Keens, a pediatric pulmonologist at the Los Angeles Children’s Hospital, said they would be together in a complete storm. Previous studies have pointed to activity and damage to parts of the baby’s brain that control heart rate, breathing, and awakening from sleep, as well as environmental stressors such as soft bedding and indirect smoking.

“Some researchers believe that some babies die of SIDS because they don’t wake up in response to dangerous situations while sleeping,” Dr. Keanes said.

Dr. Harrington and her colleagues died of 655 healthy babies, 26 babies who died of SIDS, and other causes to test if the babies of SIDS had something essentially different. We compared dry blood samples from the neonatal heel prick test of 41 babies. They found that about 9 out of 10 infants who died of SIDS had significantly lower BChE levels than the other two groups of infants.

“I was just stunned,” said Dr. Harrington, who was looking for clues. Crowdfunding for her research It’s been nearly 30 years since she lost her child to SIDS. “Parents of SIDS babies feel guilty because their children died essentially on the clock. But what we found in this study is that these babies are different from births and the differences are hidden. It’s been done and no one knew about it until now, so it’s not the fault of my parents. “

Dr. Richard Goldstein, a pediatric palliative care specialist at Boston Children’s Hospital, said the new findings support the researchers’ hypothesis that infants who die of SIDS have problems with arousal. BChE plays a role in the availability of important neurotransmitters in the wakefulness pathways of the brain. Low levels of enzymes may indicate that the brain is unable to send signals to the baby to wake up and turn his head or breathe out. “But more research is needed to understand its real importance,” said Dr. Goldstein.

What parents need to know

Although this study identifies important chemical markers in a small group of babies, it is premature to determine if extensive testing of BChE is useful.

For one thing, scientists and doctors don’t know what “normal” levels of enzymes look like. Also, Australian researchers did not measure absolute levels of the enzyme because they did not have access to fresh blood samples of BChE. There was also overlap between babies. Some infants who died from SIDS showed BChE levels within the same range as those who did not die.

“If we test all babies born, we need to make the results stand out as anomalous only for babies at very high risk,” says Dr. Keanes. Doctors and parents still have a dilemma, even though further studies have helped fine-tune BChE testing to accurately distinguish between babies who may die of SIDS and those who may lead a healthy life. Face to face. Currently, there is no intervention or treatment for low BChE levels.

Dr. Keanes said much of the advice for preventing SIDS remains the same.Please be sure to follow Safe sleep recommendations It’s like putting your baby on his back — both at nap and at night. Remove loose sheets, blankets, pillows, bumper pads and soft toys from your baby’s sleeping area. Also, consider keeping your baby in the same room at night for at least 6 months, ideally until your baby is 1 year old.

American Academy of Pediatrics recommendation Avoid exposure to smoke, alcohol and illicit drugs during pregnancy. Breastfeeding; Immunize regularly; Use a pacifier to reduce the risk of SIDS.