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Sudden infant death and home monitors
R G Meny1, L Blackmon, D Fleischmann
1Department of Pediatrics, University of Maryland School of Medicine, Baltimore.
Insights
Many infant deaths occurred despite home cardiorespiratory monitoring. Noncompliance with monitoring techniques and specific demographic factors increased risks for sudden infant death syndrome.
Area of Science:
- Pediatrics
- Public Health
Background:
- Home cardiorespiratory monitors are used for infants at risk.
- Sudden unexpected infant deaths occurred despite monitor availability.
Purpose of the Study:
- Investigate compliance with monitoring techniques.
- Identify medical and demographic factors linked to infant deaths.
Main Methods:
- Compared ten infants who died with 211 monitored infants.
- Analyzed compliance and associated risk factors.
Main Results:
- High noncompliance with monitoring techniques (60-80% of deaths).
- Increased risks associated with bronchopulmonary dysplasia, life-threatening events, black race, lack of insurance, unmarried mothers, young maternal age, smoking, and low Apgar scores.
Conclusions:
- Demographic and medical factors can predict high-risk infants for sudden death.
- Improved parent education on monitoring compliance is crucial for high-risk infants.
Abstract:
During a two-year period, ten infants died suddenly and unexpectedly with a home cardiorespiratory monitor available. We investigated the compliance with appropriate monitoring technique as well as the medical and demographic factors associated with these deaths (90% were due to sudden infant death syndrome). At least six and probably eight of these ten families were noncompliant with appropriate monitoring technique. The main comparison group consisted of 211 patients for whom care with home cardiorespiratory monitors was initiated and continued. Bronchopulmonary dysplasia and severe, apparent life-threatening events were significantly increased in the subjects, as were the following characteristics: black race; lack of private medical insurance; unmarried mother; maternal age of less than 25 years; cigarette smoking by mother during pregnancy; and low Apgar scores. These diagnostic and demographic factors may be useful in predicting the infant at highest risk for sudden and unexpected death when a home monitor is prescribed. Noncompliance with proper monitoring technique patients; methods of educating parents of infants at high risk of sudden infant death syndrome with the necessity for compliance need to be developed.