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Sudden Infant Death Syndrome: From Epidemiology to Pathophysiology

par Franco, Patricia ;Raoux, Aude;Kugener, Béatrice;Scaillet, Sonia ;Groswasser, José ;Kato, Ineko;Montemitro, Enza;Lin, Jian-Sheng
Référence Encyclopedia of Sleep, Elsevier Inc., page (638-644)
Publication Publié, 2013-01

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Résumé :

Despite the dramatic decline in the incidence of sudden infant death syndrome (SIDS) by 50-90% over the past two decades, SIDS continues to be the leading cause of death in infants aged between 1 month and 1 year in developed countries. We will review the most recent epidemiological, electrophysiological, genetic, and pathological research on this topic. From these data, a comprehensive model for SIDS has been proposed: the death would result from the combination of three factors (a prenatal vulnerability, a critical developmental period, and an exogenous postnatal stress) and three potential mechanisms (deficiencies in breathing, autonomic, and sleep-wake controls).An infant could be vulnerable to SIDS because of a deficiency in the medullary 5-hydroxytryptamine (5-HT) system due to environmental or genetic causes. This system has a key role in homeostatic functions involving respiratory, cardiovascular, and arousal controls. The infant's vulnerability lies latent until he/she enters the critical developmental period from 2 to 6 months when significant changes in sleep-wake, breathing, and autonomic controls occur. The accident has a greater probability of occurring when the infant is exposed to an infection, or an unfavorable environmental factor which enhances the immature cardio respiratory and sleep/wake behaviors of the infant.