Neonatal circumcision and prematurity are associated with sudden infant death syndrome (SIDS)
Journal Title: Journal of Clinical and Translational Research - Year 2018, Vol 4, Issue 2
Abstract
Background: Sudden infant death syndrome (SIDS) is the most common cause of postneonatal unexplained infant death. The allostatic load hypothesis posits that SIDS is the result of cumulative perinatal painful, stressful, or traumatic exposures that tax neonatal regulatory systems. Aims: To test the predictions of the allostatic load hypothesis we explored the relationships between SIDS and two common phenotypes, male neonatal circumcision (MNC) and prematurity. Methods: We collated latitudinal data from 15 countries and 40 US states sampled during 2009 and 2013. We used linear regression analyses and likelihood ratio tests to calculate the association between SIDS and the phenotypes. Results: SIDS mortality rate was significantly and positively correlated with MNC. Globally (weighted): Increase of 0.06 (95% CI: 0.01-0.1, t = 2.86, p = 0.01) per 1000 SIDS mortality per 10% increase in circumcision rate. US (weighted): Increase of 0.1 (95% CI: 0.03-0.16, t = 2.81, p = 0.01) per 1000 unexplained mortality per 10% increase in circumcision rate. US states in which Medicaid covers MNC had significantly higher MNC rates (χe = 0.72 vs 0.49, p = 0.007) and male/female ratio of SIDS deaths (χe = 1.48 vs 1.125, p = 0.015) than other US states. Prematurity was also significantly and positively correlated with MNC. Globally: Increase of 0.5 (weighted: 95% CI: 0.02-0.086, t = 3.37, p = 0.004) per 1000 SIDS mortality per 10% increase in the prematurity rates. US: Increase of 1.9 (weighted: 95% CI: 0.06-0.32, t = 3.13, p = 0.004) per 1000 unexplained mortalities per 10% increase in the prematurity rates. Combined, the phenotypes increased the likelihood of SIDS. Conclusions: Epidemiological analyses are useful to generate hypotheses but cannot provide strong evidence of causality. Biological plausibility is provided by a growing body of experimental and clinical evidence linking aversive preterm and early-life SIDS events. Together with historical and anthropological evidence, our findings emphasize the necessity of cohort studies that consider these phenotypes with the aim of improving the identification of at-risk infants and reducing infant mortality. Relevance for patients: Preterm birth and neonatal circumcision are associated with a greater risk of SIDS, and efforts should be focused on reducing their rates.
Authors and Affiliations
Eran Elhaik
Keywords
Related Articles
- EP ID EP678748
- DOI -
- Views 249
- Downloads 0
Primary headache syndromes in the elderly: epidemiology, diagnosis and treatment
Although secondary headaches due to e.g. temporal arteritis or a brain tumor are common among the elderly, primary headache disorders also occur in this age group, albeit less frequently than in younger individuals. A di...
Detection of misfolded protein aggregates from a clinical perspective
Neurodegenerative Protein Misfolding Diseases (PMDs), such as Alzheimer’s (AD), Parkinson’s (PD) and prion diseases, are generally difficult to diagnose before irreversible damage to the central nervous system damage has...
FXR agonism protects against liver injury in a rat model of intestinal failure-associated liver disease
Background: Intestinal failure-associated liver disease (IFALD) is a clinical challenge. The pathophysiology is multifactorial and remains poorly understood. Disturbed recirculation of bile salts, e.g. due to loss of bil...
Layer-by-layer heparinization of decellularized liver matrices to reduce thrombogenicity of tissue engineered grafts
Background: Tissue–engineered liver grafts may offer a viable alternative to orthotopic liver transplantation and help overcome the donor organ shortage. Decellularized liver matrices (DLM) have a preserved vasculature a...
IL-23 and IL-17A are not involved in hepatic/ischemia reperfusion injury in mouse and man
Background: Hepatic ischemia and reperfusion (I/R) is common in liver surgery and transplantation and compromises postoperative liver function. Hepatic I/R injury is characterized by sterile inflammation that contributes...