title: [Apparent life-threatening events and sudden unexpected death in infancy: Two different entities].
abstract: Most infant apparent life-threatening events (ALTEs) are minor with spontaneously favorable prognosis. Frequent etiologies are gastroesophageal reflux, obstructive apneas, respiratory infections, and breath-holding spells. Some rare but potentially serious causes must be discussed. Diagnosis is usually guided by careful questioning of the parents and repeated clinical examinations. A few complementary examinations are systematically needed and their performance is increased if they are oriented by clinical aspects. Hospitalization is usual for monitoring, further etiological investigation, and management of parental anxiety. ALTE and sudden unexpected death in infancy (SUDI) etiologies are often different. SUDI is called sudden unexplained death in infancy if it remains unexplained after investigation including autopsy. The annual incidence in France fell sharply after prevention campaigns in the 1990s, and now is about 400 SUDI, including 250 unexplained SUDI. The main guidelines of prevention are back sleeping, cessation of smoking during and after pregnancy, securing the bed and bedding, prevention of hyperthermia, and avoidance of dangerous factors of bed sharing. In the future, infants with particular vulnerabilities may be identified. The Haute Autorité de santé (French National Authority for Health) has published guidelines to support SUDI, standardize procedures, and improve our understanding of the causes of death.
authors.affiliation: Service mobile d'urgence et de réanimation (SMUR) pédiatrique, centre de référence de la mort inattendue du nourrisson (CRMIN), CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France. Electronic address: julien.naud@chu-bordeaux.fr.
authors.forename: J
authors.initials: J
authors.lastname: Naud
mesh_terms: D004630:Emergencies; D005260:Female; D005602:France / Q000453:epidemiology; D005764:Gastroesophageal Reflux / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D012127:Respiratory Distress Syndrome, Newborn / Q000453:epidemiology*; D012141:Respiratory Tract Infections / Q000453:epidemiology; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology*; D013398:Sudden Infant Death / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*