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Interaction between apnea, prone sleep position and gliosis in the brainstems of victims of SIDS.

Abstract：

:Among 27,000 infants studied prospectively to characterize their sleep-wake behavior, 38 infants died suddenly and unexpectedly under 6 months of age. Of these, 26 died from sudden infant death syndrome (SIDS), 5 from congenital cardiac abnormalities, 2 from infected pulmonary dysplasia, 2 from septic shock with multi-organ failure, 1 from a prolonged seizure, 1 from prolonged neonatal hypoxemia, and 1 from meningitis and brain infarction. The frequency and duration of apneas recorded some 3-12 weeks prior to the infants' death were analyzed. The brainstem materials were collected and studied in an attempt to elucidate the relationship between sleep apnea, and prone sleep position and gliosis in some nuclei associated with cardiorespiratory characteristics, such as nucleus ambiguus in the medulla oblongata and the solitary nucleus, as well as structures associated with arousal phenomenon, such as the reticular formation, the superior central nucleus and the nucleus raphe magnus in the pons, the dorsal raphe nuclei in the midbrain and medulla oblongata, periaqueductal gray matter in midbrain, and locus ceruleus. Gliosis was estimated as the density of glial fibrillary acidic protein (GFAP)-positive reactive astrocytes. Variant-covariant analyses were carried out using the characteristics of apnea as an independent variable and sleep position and gliosis as dependent variables. A significant association was found only in the frequency of obstructive apnea and prone position (P<0.001) and gliosis in the raphe nuclei in the midbrain (P<0.001). Although prone position is a well-known risk factor for SIDS, the frequency of obstructive apnea has not been associated with the prone sleep position. The observed relation between prone sleep and the density of gliosis does not relate to epidemiological findings. Further studies are needed to investigate the unexpected statistical association.

journal_name

Forensic Sci Int

journal_title

Forensic science international

authors

Sawaguchi T,Franco P,Kato I,Shimizu S,Kadhim H,Groswasser J,Sottiaux M,Togari H,Kobayashi M,Nishida H,Sawaguchi A,Kahn A

doi

10.1016/s0379-0738(02)00138-x

keywords:

subject

Has Abstract

pub_date

2002-09-14 00:00:00

pages

S44-52

eissn

0379-0738

issn

1872-6283

pii

S037907380200138X

journal_volume

130 Suppl

pub_type

杂志文章

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Interaction between apnea, prone sleep position and gliosis in the brainstems of victims of SIDS.