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No, this study did not find “the cause of SIDS”. Experts explain.

No, this study did not find "the cause of SIDS".  Experts explain.
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The news quickly went viral: ‘THEY FOUND THE CAUSE OF SIDS’, read a sample tweet, one of countless celebratory messages from parents elated at a new study in Australia. Many news sites claimed the study found a ’cause’ of Sudden Infant Death Syndrome: a biochemical marker that could help identify babies at risk of death.

And why wouldn’t people celebrate? SIDS kills more than 1,000 babies in the United States each year. This number is significantly lower than it was – after a successful public health campaign in the 1990s to encourage parents to put babies to sleep on their backs, SIDS deaths fell by half – but the death of every baby is overwhelming and the fear of a sleeping baby who never wakes up haunts many new parents.

But physician-scientists who have dedicated their careers to studying SIDS say the study’s findings are, perhaps understandably, overstated by people desperate for good news about infant deaths.

“It’s really preliminary,” said Richard Goldstein, MD, associate professor of pediatrics at Harvard Medical School and director of Robert’s Sudden Unexpected Death Program at Boston Children’s Hospital. “I know some of these researchers. I think it’s good research, but it’s preliminary.

the study in question, published May 6 in the journal EBioMedicine, was quite simple. Carmel Harrington, a sleep medicine specialist at Westmead Children’s Hospital, Australia, tested levels of the enzyme butyrylcholinesterase in the blood. She and two co-authors thought the enzyme might play a role in SIDS. Sure enough, in dried blood spots that had been taken during the first day or two of life, they found that in 67 infants who later died of SIDS, enzyme levels were on average only 73% higher than in children who died of other causes.

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The finding makes sense because the enzyme plays an important role in regulating the autonomic nervous system, which controls breathing, heart rate and other basic bodily functions. Infants who die of SIDS are thought to have a dysfunctional autonomic nervous system: when their blood oxygen levels drop during sleep, they remain still, rather than gasping, crying, arching their backs and rolling over. make sure they get enough air.

But the study was small, and the finding of low levels of butyrylcholinesterase in SIDS was the first time such an observation had been made. So doctors say it needs to be replicated in a larger group before taking it seriously.

Additionally, according to the researchers, while the lower level of the enzyme in SIDS infants was statistically significant by one measure, it was not significant by another more common statistical test, so the association could be purely due to chance.

“I wish that were true,” said Jose Javier Otero, MD, PhD, associate professor and director of neuropathology at The Ohio State University College of Medicine, where he studies potential biomarkers for SIDS. “It’s what everyone would like to have: something simple that you can test in blood. That’s why it’s exciting. But whether this is true or not is highly uncertain.

Another problem with the study, the two doctors said, is that it doesn’t include any information about the infants’ birth weight, or age, blood pressure, or use of alcohol, tobacco or tobacco. drug use – all key risk factors for SIDS.

“One of the biggest predictors of SIDS risk is the baby’s birth weight,” Otero said. “Could the level of this enzyme simply reflect whether the infant was born with a very low birth weight?”

Given the preliminary results of the Australian study, how did it generate such excitement among the public? This could be attributed to a Press release posted online May 7 by the Sydney Children’s Hospitals Network, where the researchers are based. The title of the press release read: “A first global breakthrough could prevent SIDS. Its first sentence said that SIDS “could soon be a thing of the past thanks to a first global breakthrough”.

In an email to The Post, a spokesperson for the hospital network explained their statement: “We consider the results of this study a breakthrough in research because it is the first time that researchers have found a marker for SIDS. while the infant is still alive. . Other biomarkers have been studied but only on post-mortem samples. It is the fact that this marker can be detected before death that opens up so much potential for future research.

A pediatrician who has published more than two dozen scientific papers on SIDS said she agrees that finding a possible marker for future risk of SIDS while the child is still alive is “exciting”.

“Other studies have found factors after the child’s death,” said Debra E. Weese-Mayer, professor of pediatrics at Northwestern University Feinberg School of Medicine and director of the Center for Autonomic Medicine in Pediatrics. “Is this a perfect study? No. But if you’re careful not to over-interpret the results, it adds a possible new piece to the SIDS puzzle.

She and Goldstein, however, expressed concern that the excessive media coverage surrounding the new journal could cause some parents to lose sight of proven risk factors for SIDS that are within their control: making sure infants are not exposed to tobacco smoke and put to sleep on their backs, with firm bedding and no bumpers or soft pillows.

“I worry that parents might mistakenly think that risk factors are no longer relevant or less so, and that would be more than unfortunate,” Goldstein said.

The three doctors said they found it baffling that the Australian study is receiving so much attention when other recent studies on SIDS have been mostly ignored. In April, for example, a study describes a “safe sleep calculator” that accurately identified 83% of infants before they died from SIDS. Another study published last month and led by Goldstein, identified new genetic variants that play a role in SIDS.

“Both the risk calculation paper and the genetic study were very interesting,” Weese-Mayer said. “But we doctors have no control over the press releases our hospitals send out.”

One of the concerns doctors have about claims of a “breakthrough” in SIDS research is that it could mislead people into thinking great progress is being made in the field, Goldstein said. Indeed, according to a perspective he co-wrote in the New England Journal of Medicine last week, the pace of research stalled decades ago after the roles of bedding and sleep positioning were identified.

Still, Goldstein said he’s glad to see all the attention on SIDS, even if the coverage sometimes gets ahead of the science.

“SIDS is an issue that deserves more attention than it gets,” he said. “It is the leading cause of death in infants between one month and one year old, and nearly one in every 1,000 American newborns dies from it. This is not a solved problem. It always helps to raise awareness.

While not a breakthrough, Weese-Mayer said she nonetheless found the study inspiring. The first author of the paper, she noted, began researching SIDS two decades ago after the death of her child.

“This was a study driven by the passion of a mother and a scientist,” Weese-Mayer said. “And she funded the study through a go-fund-me campaign. This should inspire other scientists to know that they don’t always have to wait for traditional funding sources. If you’re determined to do a study, you find a way.

Do you have a question about parenthood? Ask for La Poste.

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