Current controversies in the pathophysiology and prevention of sudden infant death syndrome.
OBJECTIVE
To examine recent research relevant to sudden infant death syndrome (SIDS) to determine whether there is a place for home monitoring in the care of children believed to be at risk.


RESULTS
Current SIDS research has focused on the genetics of SIDS, brainstem abnormalities and arousal failures, the effects of tobacco smoke and other environmental agents, the role of infectious diseases, and prenatal factors that may contribute to SIDS. Investigations have suggested that there are infants who appear to respond less effectively when challenged by certain environmental or infectious agents. These infants have blunted responses to stress and diminished arousal to hypoxemia, in part because of failures in genetically determined brainstem function. It is unclear at this time whether home monitoring would offer protection in all circumstances, but it may be helpful in certain patients.


CONCLUSIONS
There appears to be progress in understanding the causes of SIDS. As additional studies emerge, the optimal approaches to care will become more apparent, with home monitoring one of the possible interventions.
Spitzer
Alan R
AR
Center for Research and Education, Pediatrix Medical Group, Sunrise, Florida 33323, USA. alan_spitzer@pediatrix.com
D001933:Brain Stem / Q000002:abnormalities / Q000503:physiopathology*; D003141:Communicable Diseases / Q000150:complications; D006699:Home Care Services; D006801:Humans; D007231:Infant, Newborn; D008991:Monitoring, Physiologic; D012307:Risk Factors; D013398:Sudden Infant Death / Q000209:etiology / Q000517:prevention & control*