Postnatal parental smoking: an important risk factor for SIDS

Sudden infant death syndrome (SIDS) is the unexpected death of an infant that remains unexplained after a thorough investigation of the circumstances, family history, paediatric investigation and complete autopsy. In Western society, it is the leading cause of post-neonatal death below 1 year of age. In the Netherlands, the SIDS incidence is very low, which offers opportunities to assess the importance of old and new environmental risk factors. For this purpose, cases were collected through pathology departments and the working group on SIDS of the Dutch Paediatrician Foundation. A total of 142 cases were included; these occurred after the parental education on sleeping position (1987), restricted to the international age criteria and had no histological explanation. Age-matched healthy controls (N = 2,841) came from a survey of the Netherlands Paediatric Surveillance Unit, completed between November 2002 and April 2003. A multivariate analysis was performed to determine the risk factors for SIDS, including sleeping position, antenatal maternal smoking, postnatal parental smoking, premature birth, gender, lack of breastfeeding and socio-economic status. Postnatal smoking was identified as an important environmental risk factor for SIDS (OR one parent = 2.5 [1.2, 5.0]; both parents = 5.77 [2.2, 15.5]; maternal = 2.7 [1.0, 6.4]; paternal = 2.4 [1.3, 4.5] ) as was prone sleeping (OR put prone to sleep = 21.5 [10.6, 43.5]; turned prone during sleep = 100 [46, 219]). Premature birth was also significantly associated with SIDS (OR = 2.4 [1.2, 4.8]). Postnatal parental smoking is currently a major environmental risk factor for SIDS in the Netherlands together with the long-established risk of prone sleeping

A 15th Century Bambino is the Symbol of Global Maternal and Child Health.

JOURNAL ARTICLESCOPUS: no.jinfo:eu-repo/semantics/publishe

Environment and early developmental care

The spectacular development of neonatal intensive care since the 1960s has allowed a drop in neonatal mortality of verylow- birth-weight (VLBW) infants from 50% to less than 15% in the last decade [1]. However 15 to 25% of the VLBW infants will present neurodevelopment impairment in the following fields: motor function, vision, auditory function, cognition, behavior, attention deficit and hyperactivity disorders, visual-motor integration and language [2, 3]. Compared to their term pairs there is substantial scientific evidence of altered early brain development [4]. These infants spend weeks and sometimes months in the neonatal intensive care unit (NICU), which is a quite different environment compared to what they would experience in utero. At this young age brain growth and development is particularly critical. The configuration of neurons is genetically predetermined, but the further organization and wiring of the neural circuits will depend on endogenous and exogenous stimulation. The existing evidence of interaction between environment and brain development has been extensively reviewed and better practices encouraged [5]. It is against the background of the potential harmful effects of the traditional NICU that developmental care and environmental strategies have gained more and more attention.SCOPUS: ch.binfo:eu-repo/semantics/publishe