婴儿猝死综合征的流行病学

婴儿猝死综合征（ＳＩＤＳ）的死亡率各国报道不一。西方国家因其为婴儿主要死亡原因而进行了大量的流行病学研究。本文从ＳＩＤＳ的年龄、性别、种族、季节分布及睡眠体位、过热、母亲孕期吸烟、是否母乳喂养等相关因素方面进行了综合描述，并提出在我国开展ＳＩＤＳ流行病学研究的实际意义。     

婴儿啼哭的声谱分析

使用声谱分析婴儿与临床问题有关的异常哭声的声学特征是一门新的学科，本文参阅国外近年来从生物、社会角度使用哭声分析工具对婴儿啼哭的研究资料发现，对婴儿啼哭的计算机分析，对新生儿猝死、早产儿神经系统的长期发育提供了具有诊断价值的意义，并对妊娠母亲吸毒、酗酒及负中毒婴儿啼哭的前瞻性研究提供了理论依据；又从社会角度对婴儿啼哭的母婴关系发展及婴儿的社会行为健康发展具有指导意义。总之应在我国有条件开展婴儿啼哭分析中，提高临床质量及为护理提供理论依据。     

婴儿啼哭的声谱分析

使用声谱分析婴儿与临床问题有关的异常哭声的声学特征是一门新的学科,本文参阅国外近年来从生物、社会角度使用哭声分析工具对婴儿啼哭的研究资料发现,对婴儿啼哭的计算机分析,对新生儿猝死、早产儿神经系统的长期发育提供了具有诊断价值的意义,并对妊娠母亲吸毒、酗酒及铅中毒婴儿啼哭的前瞻性研究提供了理论依据;又从社会角度对婴儿啼哭的母婴关系发展及婴儿的社会行为健康发展具有指导意义.总之应在我国有条件开展婴儿啼哭分析中,提高临床质量及为护理提供理论依据.     

读懂婴儿的啼哭

小宝宝又哭了,这是怎么了?年轻的父母常常有此疑问。其实,婴儿啼哭是一种本能,是表达生理需求或痛苦不适的一种方式,也是婴儿传递某种信息的特殊语言。婴儿正常的啼哭可以使肺泡扩张,增加肺活量,有利于婴儿的生长发育。对于婴儿,不要一听到     

预防婴儿“猝死综合征”

生活中有些婴儿通常在没有任何征兆的情况下突然死亡,令家长们措手不及。给家庭带来巨大的痛苦和打击。那么,造成这种不幸的罪魁祸首是谁呢？     

婴儿安全睡眠保护策略的证据总结

目的系统评价国内外婴儿安全睡眠保护策略的相关证据,并对证据进行总结,为临床循证决策及指南的制定提供参考。方法以“婴儿/新生儿”“死亡/婴儿猝死综合征”“睡眠保护策略/安全睡眠/睡眠”和“Infant Death/Sudden Unexpected Infant Death/Sudden Infant Death Syndrome”“Sleep protecting program/Sleep safety/Sleeping environment”为关键词,系统检索美国国立指南网、加拿大安大略省注册护士协会、英国国家卫生与照护优化研究所、苏格兰校际间指南网、国际指南协作网、UptoDate、Embase、中国知网、万方等数据库截至2020年3月发表的关于婴儿睡眠安全保护策略的文献。纳入标准为以0~1岁的婴儿为研究对象,以婴儿安全睡眠保护策略或护理为主题的指南、证据总结及系统综述,并可获取全文。排除标准包括重复收录、直接翻译的文献及指南的摘要、讨论稿、指南草案、解读、节选等。采用欧洲指南研究与评估工具(AGREEⅡ)和系统评价方法学质量评价工具(AMSTARⅡ)对筛选的文献进行比较和评价,并对符合质量标准的文献进行证据提取。结果共纳入12篇文献,包括来自UptoDate的证据总结1篇,指南3篇,系统综述8篇。AGREEⅡ质量评价结果显示,3篇指南整体质量较好,其中推荐等级为“A”的有1篇,等级为“B”的有2篇;AMSTARⅡ质量评价显示,系统综述的质量除1篇文献外,内容均较为完善。最终形成证据总结39条,包括评估、计划、实施、健康教育(孕产妇、父母及其他婴儿照护者)、评价及组织与政策6个方面。结论婴儿安全睡眠保护的证据总结,为制定婴儿安全睡眠护理规范,开展科学、高质量的临床护理实践提供了证据支撑。     

婴儿猝死综合征病因学新发现

婴儿猝死综合征为一多因素致病急症，至６０年代初期，各国学者就提出了众多的病因学说，近年又有新的发现。①体内肉硷缺乏导致脂肪氧化障碍；②体内微量元素硒缺乏导致甲状腺功能减退及谷胱甘肽过氧化酶合成障碍；③生前无症状的肺含铁血黄素沉着症；④产气荚膜梭状芽胞杆菌感染；⑤母亲在妊娠时多不饱和脂肪酸摄入不足至婴儿脑及神经髓鞘发育不良；⑥由于文化因素，传统育儿习惯造成一些不良因素。本文就以上新观点作一综述。     

婴儿啼哭研究的进展

婴儿啼哭是造成家庭混乱和母亲产后第一年最普通的报怨原因之一。它也是儿科门诊主要成分之一.婴儿啼哭也涉及一个儿童发展的养育理论,这就是人类研究婴儿啼哭的目的.     

Risk factors of sudden infant death syndrome and risk factors for sleep disturbances

Relationship between major risk factors of sudden infant death syndrome (SIDS) and sleep disorders in the infants is the subject of review and discussion. Improper micro‐environmental characteristics (especially poor environmental organisation and lack of developmental stimulation), pre‐term delivery and/or infant low birth weight, prone sleep position, maternal smoking during pregnancy, and infant–parent(s) bed‐sharing are among well‐established risk factors of SIDS. These factors may also be associated with sleep disorders in infants, principally with bedtime problems, abnormal night awakenings, and arrhythmic sleep. As an attempt to fix sleep problems, some inexperienced parents may try infant‐rearing practices that may only aggravate sleep troubles and lead to further increased risk of SIDS, thus giving start to a vicious circle. Health care providers need to be aware of such situations as an opportunity to provide parents with guidance with respect for individual infant and family characteristics.     

基于CiteSpace国内婴儿哭声研究领域的知识图谱分析

目的 分析国内婴儿哭声研究领域的现状,探索该领域国内研究热点,旨在为婴儿哭声领域科研工作提供一定思路和依据。方法 检索CNKI建库至2021年12月期间所收录的婴儿哭声相关研究文献,运用CiteSpace软件对纳入文献从发文量、作者、机构、关键词、突现5个方面进行可视化分析。结果 共纳入190篇文献,1980—2021年间该领域发文量整体呈上升趋势;研究作者较少,作者间合作网络尚未形成;研究机构之间交互性差,发文量最多的是杭州医学院及其附属医院;“护理干预”、“哭声信息识别”、“深度学习”为该领域研究热点;“护理”、“新生儿”、“婴儿哭声”、“深度学习”为该领域研究前沿;研究趋势由新生儿病理性哭声研究转向婴儿哭声针对性干预、深度学习。结论 国内婴儿哭声领域受到更多重视,未来应强化作者和机构间的合作交流,融合多学科发展,扩大研究范围,可从婴儿情感需求分析、智能医学与监护、新型护理干预方法等方面着手,加速国内婴儿哭声研究进程。     

Ethnic differences in rates of infant mortality and sudden infant death in Sweden, 1978-1990

This study examined ethnic differences in infant mortality rates(IMRs) and rates of sudden infant death syndrome (SIDS) amongSwedish and immigrant women between 1978 and 1990 in Sweden.The study population comprised 1,265,942 single live birthsto women between the ages of 15 and 44 years in Sweden. Datafrom 3 registers In Sweden were linked to obtain medical andsociodemographic information for each mother and child in thestudy. Logistic regression analyses were employed to assessethnic differences in infant mortality and SIDS while controllingfor relevant confounders. This study revealed no ethnic differencesin IMRs. There were also no ethnic differences in the mortalityrates due to SIDS, except for immigrant women from SoutheastAsia and the Pacific Islands who experienced significantly higherrates of SIDS than Swedish women. This study shows that, ingeneral, the IMRs and mortality rates due to SIDS are not aserious public health problem among immigrant women in Swedenand suggests several reasons why this is the case.     

Differing Postneonatal Mortality Rates of African-American and White Infants in Chicago: An Ecologic Study

Objectives: This study sought to determine whether neighborhood impoverishment explains the racial disparity in urban postneonatal mortality rates. Methods: Stratified and multivariate logistic regression analyses were performed on the vital records of all African-Americans and whites born in Chicago by means of a linked 1992–1995 computerized birth–death file with appended 1990 U.S. census income and 1995 Chicago Department of Public Health data. Four community-level variables (low median family income, high rates of unemployment, homicide, and lead poisoning) were analyzed. Communities with one or more ecologic risk factors were classified as impoverished. Results: The postneonatal mortality rate of African-Americans (N = 104,656) was 7.5/1000 compared to 2.7/1000 for whites (N = 52,954); relative risk (95% confidence interval) equaled 2.8 (2.3–3.3). Seventy-nine percent of African-American infants compared to 9% of white infants resided in impoverished neighborhoods; p < 0.01. In impoverished neighborhoods, the adjusted odds ratio (controlling for infant and maternal individual-level risk factors) of postneonatal mortality for African-American infants equaled 1.5 (0.5–4.2). In nonimpoverished neighborhoods, the adjusted odds ratio of postneonatal mortality for African-American infants equaled 1.8 (1.1–2.9). Conclusions: We conclude that urban African-American infants who reside in nonimpoverished neighborhoods are at high risk for postneonatal mortality.     

Weather and the risk of sudden infant death syndrome: the effect of wind

STUDY OBJECTIVE—To examine and identify relations between sudden infant death syndrome (SIDS) and wind, particularly the föhn wind, in Christchurch, New Zealand.
DESIGN—A retrospective epidemiological study combining details of regional hourly meteorological variables and reported SIDS cases.
SETTING—Christchurch, New Zealand, between 1968 and 1997 inclusively.
PARTICIPANTS—All 646 infants reported as dying from SIDS within the greater Christchurch region.
MAIN RESULTS—Analysis of 1968-1989 data revealed nine wind variables significantly related to SIDS. When compared with corresponding variables calculated over the 1990-1997 period, only the northerly wind on the day of death and the southerly wind three days before a SIDS death had estimated associations with similar effect size and sign. However, both these variables had confidence intervals that included unity.
CONCLUSIONS—No evidence was found to suspect that föhn winds influenced SIDS occurrence. The relations identified between SIDS incidence and wind, after controlling for the effects of temperature and trend, were tenuous and relatively small. More data are necessary to substantiate whether northerly winds on the day of death or southerly winds occurring three days before a death are truly associated with SIDS. It seems that wind has little, if any effect on SIDS incidence in Christchurch.


     

Evaluation of child care practice factors that affect the occurrence of sudden infant death syndrome: Interview conducted by public health nurses

We examined the child-rearing environmental factors that affect the occurrence of sudden infant death syndrome (SIDS) using a nationwide survey. Infants who died due to SIDS between January 1996 and June 1997 in Japan were identified from death certificates. Controls of the same gender, birthplace, and birth months as the corresponding SIDS were chosen from birth certificates. Interviews of both cases and controls were undergone in January and February, 1998 by public health nurses. The following child-rearing factors exhibited a significant relationship with the occurrence of SIDS: Concerning the sleeping position, the prone position was associated with increased risk compared with the supine position, with an odds ratio of 3.02 (95% c.i. 2.07–4.65). Regarding the feeding method, artificial feeding alone demonstrated a higher risk than breast feeding alone, with an odds ratio of 4.92 (95% c.i. 2.78–9.63). With regard to smoking, infants with both parents who smoked exhibited a higher risk than infants where neither parent smoked, with an odds ratio of 3.50 (95% c.i. 1.74–8.32).     

Infant temperament characteristics related to sudden infant death syndrome and its risk factors

Three major components have been repeatedly implicated for the origin(s) of sudden infant death syndrome (SIDS): system, minor sickness and surroundings. All these factors also frame infant temperament, and therefore it seems logical to suppose that the babies who either succumb to or are at risk of SIDS may present with certain behavioural features. The infants who have died of SIDS moved less when lying awake in the crib, during feeding and during nail cutting; less often turned their head away and looked for their mother when held by a new person; were more frequently reported to show an extreme response (either almost never protested or almost always objected) when approached by someone other than main caregiver; and exhibited extreme behavioural patterns when the infant's vocalising on waking up was studied. The infants who died of SIDS had lower activity scores. An unfavourable microenvironment can increase the risk of SIDS, and the babies facing less developmental stimulation had a more negative mood and were less distractible; less organised infants presented with a more negative mood, less distractible behaviour, lower rhythmicity, lower persistence and lower adaptability. The infants born to smoking mothers who are at risk of SIDS had more intensive reactions. The low-birth-weight infants who are at high risk of SIDS were more withdrawing and less adaptable. Infant-parent(s) bed sharing may increase the risk of SIDS, and solitary sleeping infants had a more positive mood and were more persistent. Use of a pacifier may be protective against SIDS, and pacifier users presented with higher rhythmicity. Prone sleep is known to increase the risk of SIDS, and the lowest persistence was a feature of those babies who were usually put to sleep supine and found prone. Infants who snored and/or had noisy breathing in sleep were characterised by more negative mood. Infants with signs of repetitive regurgitation were less distractible.     

The value of the acoustic analysis of pathological infant cry and breathing noise in everyday practice

During a period of twenty years [1969-1988] the author has observed 614 cases of congenital malformations and noninflammatory diseases of the larynx in infants and young children, Budapest. He summarizes the most characteristic symptoms of laryngeal pathology in infants, and discusses the diagnostic possibilities. Among the latter, spectrographic analyses complemented by auditory evaluation of pathological cry and different breathing noises play an important role. Based on his investigation author differentiates 20 kinds of pathological crying sounds and 4 basic forms of stridor. He describes the acoustic attributes of different pathological sound phenomena and summarizes characteristic voice changes.     

Underdiagnosis of Conditions Associated with Sudden Cardiac Death in Children - Is it the Absence of a Comprehensive Screening Program or a True Low Prevalence?

This study aimed to assess the prevalence of conditions associated with sudden cardiac death (SCD) among all children and children with sudden infant death syndrome (SIDS) in the State of Hawai‘i, where no comprehensive screening program is conducted for such conditions. A retrospective chart review was conducted from the single tertiary pediatric hospital in Hawai‘i, from offices of all pediatric cardiologists in Hawai‘i, and the Hawai‘i State Department of Health from 1/1/2000 to 12/31/2013. Children aged 0–18 years were included in the study. A subset of the study analyzed records of infants aged 0–12 months. SIDS rate was calculated and compared to national data. Prevalence was calculated for known conditions associated with SCD. The identified prevalence was compared to the established prevalence of conditions associated with SCD.In Hawai‘i, the infant SIDS rate (66.4/100,000) was similar to the national rate (54.4/100,000). Over 14 years, only 51 children were diagnosed with a condition associated with SCD; 28 with a cardiomyopathy and 21 with a channelopathy. A 14-year retrospective analysis in the State of Hawai‘i revealed that less than 1 in 30 children, who are expected to harbor a SCD-associated condition, had been appropriately diagnosed. The underdiagnosis of conditions associated with SCD reflects that in the absence of a comprehensive screening program, conditions without obvious signs and symptoms are difficult to diagnose. Many children with these conditions will remain at risk of SCD.     

Air pollution and postneonatal infant mortality in the United States, 1999-2002

OBJECTIVE: Our goal was to evaluate the relationship between cause-specific postneonatal infant mortality and chronic early-life exposure to particulate matter and gaseous air pollutants across the United States. METHODS: We linked county-specific monitoring data for particles with aerodiameter of < or = 2.5 microm (PM2.5) and < or = 10 microm (PM10), ozone, sulfur dioxide, and carbon monoxide to birth and death records for infants born from 1999 to 2002 in U.S. counties with > 250,000 residents. For each infant, we calculated the average concentration of each pollutant over the first 2 months of life. We used logistic generalized estimating equations to estimate odds ratios of postneonatal mortality for all causes, respiratory causes, sudden infant death syndrome (SIDS), and all other causes for each pollutant, controlling for individual maternal factors (race, marital status, education, age, and primiparity), percentage of county population below poverty, region, birth month, birth year, and other pollutants. This analysis includes about 3.5 million births, with 6,639 postneonatal infant deaths. RESULTS: After adjustment for demographic and other factors and for other pollutants, we found adjusted odds ratios of 1.16 [95% confidence interval (CI), 1.06-1.27] for a 10-mug/m3 increase in PM10 for respiratory causes and 1.20 (95% CI, 1.09-1.32) for a 10-ppb increase in ozone and deaths from SIDS. We did not find relationships with other pollutants and for other causes of death (control category). CONCLUSIONS: This study supports particulate matter air pollution being a risk factor for respiratory-related postneonatal mortality and suggests that ozone may be associated with SIDS in the United States.