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283 SERIOUS CARDIORESPIRATORY EVENTS ARE UNLIKELY TO BE PRECURSORS TO SUDDEN INFANT DEATH SYNDROME.
  1. T. Hoppenbrouwers,
  2. J. Hodgman,
  3. A. Ramanathan,
  4. X. Liu,
  5. F. Dorey
  1. Division of Neonatology, Neonatal Medicine, Biostatistics, LAC+USC Medical Center, Women's and Children's Hospital and Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA

Abstract

The Collaborative Home Infant Monitoring Evaluation (CHIME) revealed a high incidence of cardiorespiratory events in preterm infants but at the age of highest risk for sudden infant death syndrome (SIDS), the incidence of these events was indistinguishable statistically from those of term infants. The argument that serious events are not precursors to SIDS would be bolstered if epidemiological risk factors were not correlated with events, once prematurity is controlled. SIDS risk factors examined were low maternal age and education, African American ethnicity, premature rupture of the membranes (PROM), maternal smoking, male gender, and parity ≥ 2. Additional variables examined: Asian ethnicity, placenta previa, C-section, and BPD. Serious events, apnea ≥ 30 sec, accompanied by either bradycardia (≤80 bpm for 5 sec in infants ≤ 40 wks and ≤ 60 bpm in infants > 40 wks), oxygen desaturation (≤ 90% for 5 sec) or both, were examined in 345 term and 412 preterm infants if their monitoring duration exceeded 50 hours. Only babies with PMA ≤ 44 weeks were evaluated. Prematurity, the number of hours monitored, and postmenstrual age (PMA) were highly predictive of having at least one extreme event; therefore, prematurity and monitoring hours were always used as covariates in a multivariate logistic regression analysis. None of the SIDS risk factors were significantly related to having at least one serious event, including low education (OR = 0.94, p = .107), African American ethnicity (OR = 0.7, p = .35), PROM (OR = 0.9, p = .334), maternal smoking (OR = 0.9, p = .751), male gender (OR = 0.7, p = .122), and parity ≥ 2 (OR = 0.7, p = .118). Of the remainder, only placenta previa exhibited a significant odds ratio (OR 5.6 p = .008). A lack of correlation between serious events and SIDS risk factors argues against their precursor status.

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