Health

New study gives clues as to why some babies die from SIDS


Scientists in Australia have found that some babies at risk of sudden infant death syndrome, or SIDS, have low levels of an enzyme called butyrylcholinesterase (BChE) in their blood. Their study, published May 6 in the journal eBioMedicine, could pave the way for newborn screening and intervention if the results are corroborated by further studies.

“This is the first time we have a potential biomarker for SIDS,” said Dr Carmel Harrington, who led the study at Westmead Children’s Hospital, in Sydney, Australia.

Researchers have been trying to uncover the biological underpinnings of puzzling syndromes for decades. And while public health campaigns have greatly reduced the incidence of SIDS, it remains the leading cause of sudden and unexpected death in infants under 1 year of age in Western countries. In the United States, about 3,400 infants die suddenly and unexpectedly each year, according to the Centers for Disease Control and Prevention. This includes infants who die suddenly from a known cause, such as suffocation, as well as those who die for unknown reasons, such as from SIDS. Nearly half of all sudden and unexpected infant deaths (SUIDs) in the US are due to SIDS.

One of the reasons SIDS remains so tragic and mysterious is that it may not be caused by a single biological mechanism, but by a combination of factors that come together during an attack. perfect storm, said Dr. Thomas Keens, a pediatrician at Children’s Hospital Los. Angeles. Previous studies have shown low activity or damage in parts of an infant’s brain, such as heart rate control, breathing, and feelings of euphoria during sleep, as well as stressors from the environment such as soft bedding or secondhand smoke.

“The thinking of the researchers is that some infants die of SIDS because they don’t wake up to deal with a dangerous situation while they are asleep,” Dr. Keens said.

To check if there is something inherently different in SIDS children, Dr Harrington and her colleagues compared dried blood samples from the infant heel prick test of 655 healthy children, 26 children died from SIDS and 41 children died from other causes. They found that about nine out of ten infants who died of SIDS had significantly lower levels of BChE than those in the other two groups.

Dr Harrington, who has been searching for clues and crowdfunding her research for almost 30 years, said: “I’m really surprised, since she lost one of her children. into the hands of SIDS. “Parents of SIDS children carry a huge guilt because their child essentially died in their arms. But what we found with this study is that these babies are different from birth, the difference is hidden, and nobody knows about it before. So it’s not the parents’ fault.”

Richard Goldstein, a pediatric palliative care specialist at Boston Children’s Hospital, said the new findings add further support to the researchers’ hypothesis that infants who die of SIDS have problems with their health. stimulate. BChE plays a role in the delivery of important neurotransmitters in the brain’s excitatory pathways. Low levels of the enzyme may indicate that the brain is unable to send a signal telling the baby to wake up and turn his or her head or gasp. “But we need a lot more research before we can understand what it really means,” says Dr. Goldstein.

Although the study identified an important chemical marker in a small group of infants, it is too soon to say whether widespread BChE testing would be helpful.

First, scientists and doctors don’t know what “normal” levels of enzymes look like. And because the Australian researchers did not have access to fresh blood samples for BChE, they were unable to measure absolute levels of the enzyme. There was also overlap between infants. Some infants who died of SIDS had BChE levels in the same range as those who did not.

“If you’re going to test every baby that’s born, you want the results to show abnormality for babies who are at very high risk for the disease,” Dr. Keens said. Even as further studies help refine BChE testing to accurately distinguish between infants who may die of SIDS and those who can go on to live healthy lives, doctors and parents still face a dilemma. Dilemma: What to do next? Currently, there is no intervention or treatment for low BChE levels.

Dr. Keens says much of the advice for preventing SIDS remains the same. Make sure you follow safe sleep recommendations like placing your baby on his or her back – both for naps and at night. Remove bed sheets, blankets, pillows, cushions and soft toys from your baby’s sleeping area. And consider keeping your child in the same room as you at night for at least six months, or ideally, until your child turns a year old.

The American Academy of Pediatrics also recommends avoiding exposure to smoke, alcohol, and illegal drugs during pregnancy; breastfeeding; routine immunizations; and using pacifiers to reduce the risk of SIDS.



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