Understanding the mechanisms mediating Sudden and Unexpected Death in Childhood
This study aims to better understand the underlying mechanism mediating sudden and unexpected death in childhood. In order to achieve this goal researchers from around the world are uniting to form effective collaborative networks.
One of the greatest human tragedies is the sudden unexpected death of a child—when that death remains unexplained, it is even more devastating for the parents, the family, and society at large. Fortunately the sudden unexplained death of a child (SUDC), which is defined as the sudden and unexpected death of a child over the age of 12 months which remains unexplained after a thorough case investigation is conducted, is rare – occurring mainly in toddlers with an incidence of 1.2/100,000 in the United States.
Yet, it is this very rarity that makes research into the causes and mechanisms of SUDC almost intractable. Indeed, it is virtually impossible for any one investigator to accrue a sufficient number of cases to determine commonalities among them—the critical clues that lead to testable hypotheses and evidence-based scientific inquiry necessary to determine the ultimate means of prediction and prevention. Thus, it is essential that investigators come together to pool their ideas, drive, and resources and study SUDC in a concentrated world-wide effort.
The Cooper Trewin SUDC Research Fund, in partnership with SIDS and Kids, announces its support of the development of an international initiative between Australia (Dr. Jhodie Duncan, Florey Institute of Neuroscience and Mental Health) and the United States (Professor Hannah Kinney, Children’s Hospital Boston/Harvard) to perform SUDC research through the organising leadership of the SUDC program at Children’s Hospital Boston. This initiative involves support in the transition and infrastructure-building period, as well as support for shared research studies into potential brain mechanisms underlying SUDC. The project also includes investigation of a new research program that explore the link between SUDC and potential serotonergic brainstem pathology as seen in Sudden Infant Death Syndrome, that is is death in SUDC cases mediated by the same factors as SIDS but occurs at a later time point in life?
Thus this project represents a critical opportunity to rethink and reshape the direction of SUDC research and to build into it for the first time the infrastructure for international collaborative endeavours with Australian and overseas researchers.
The overriding goal is to identify why children, who seem normal and health, may die suddenly and unexpectedly and is this related to abnormalities in the brain. The next step would be to implement intervention strategies to prevent an adverse outcome.
Sudden unexpected early neonatal death or collapse in previously healthy term infants in the first 7 days of life
The study aims to establish the current incidence of sudden unexplained death or collapse in the early neonatal period (first 7 days of life) in Australia.
The incidence of sudden unexpected and unexplained death or neonatal collapse is reported as between 0.035/1000 to 0.4/1000 live births. Greater than half of these infants die.
There is currently no national system available in Australia for investigating and reporting these cases.
The study also aims to document the risk factors and outcomes for such cases in Australia, as well as preventative strategies.
In the reported literature many of these infants are found face down on the mother’s breasts suggesting that airway compromise may be a contributing factor. Other risk factors include maternal analgesia, bed-sharing and prone sleeping.
Examination of neonatal sudden unexplained death in infants in NSW has found that the history, examination, and the death scene investigations are incomplete and under investigated.
A recent study using the British Paediatric Surveillance Unit, showed that in 30 of 45 cases there was no identified underlying disease/abnormality but in 24 there was clinical or pathological evidence of airway obstruction while breastfeeding or in a prone position. The authors called for development of guidelines for safe postnatal care of infants, especially for new mothers.
The failure to register on a population wide basis means national guidelines for safe sleeping are inadequate especially in this early postnatal group, as most definitions of SIDS commence after day 7 or 28 days of life.
It is anticipated that the information obtained as a result of this study will lead to the development and initiation of policy directives aimed at safe postnatal management of healthy newborns. Preventative strategies including education programs for parents and carers are important in reducing the incidence of these conditions.
Published Research Lists
You can download a copy of the Research Lists in PDF format below: