The Sudden Infant Death Syndrome (SIDS) remains a leading cause of infant deaths inspite of recent highly successful public health interventions designed to reduce SIDS risks (The U.S. """"""""Back to Sleep"""""""" campaign, """"""""BTS""""""""). We propose to study several physiologic and neuro-developmental mechanisms potentially involved in the etiology of SIDS, as well as, pertinent environmental factors. The research will focus on three areas. In the first of these, we plan to study the physiology of recovery from severe hypoxia by gasping (autoresuscitation, AR). These studies will determine if the previously documented developmentally acquired defect in AR, originally described in SWR mice, is present in other inbred strains and species and, furthermore, if underlying mechanisms causing AR failure are similar to those in SWR mice. Additionally, the effects of increased environmental temperature on AR will be evaluated. Also, Home apnea monitor recordings of infants dying suddenly and unexpectedly while being monitored will be studied to determine if there is evidence of attempted AR and if so, potential reasons for its failure. The second part of our studies will be directed to prospectively obtaining data on the case history, death scene and postmortem examination of infant's dying with the diagnoses of SIDS, accidental suffocation and """"""""cause of death undetermined"""""""" in the St. Louis metropolitan area.
The aim i s to determine how many of these deaths are preventable by public acceptance of current """"""""BTS"""""""" guidelines and how many might be prevented by future additions or changes in the recommendations to child caretakers. In connection with this study, we will perform special death scene investigations in certain SIDS and accidental suffocation deaths combined with laboratory death scene reconstruction studies in order to determine if additional simple guidelines for parents and child equipment manufactures can be formulated in order to prevent infant deaths. Finally, we will study development of the infant's ability to avoid potentially suffocating environments during sleep, and determine the potential role of the infant's past experience on this development.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
5R01HD010993-27
Application #
6612628
Study Section
Human Embryology and Development Subcommittee 1 (HED)
Program Officer
Willinger, Marian
Project Start
1977-09-30
Project End
2004-05-31
Budget Start
2003-06-01
Budget End
2004-05-31
Support Year
27
Fiscal Year
2003
Total Cost
$338,882
Indirect Cost
Name
Washington University
Department
Pediatrics
Type
Schools of Medicine
DUNS #
068552207
City
Saint Louis
State
MO
Country
United States
Zip Code
63130
Kinney, Hannah C; Thach, Bradley T (2009) The sudden infant death syndrome. N Engl J Med 361:795-805
Thach, B T; Kenney-Hunt, J P; Simon, T C et al. (2009) Sex-specific quantitative trait loci linked to autoresuscitation failure in SWR/J mice. Heredity (Edinb) 103:469-75
Song, Z; Harris, K A; Thach, B T (2009) Laryngeal constriction during hypoxic gasping and its role in improving autoresuscitation in two mouse strains. J Appl Physiol (1985) 106:1223-6
Thach, Bradley T (2009) Does swaddling decrease or increase the risk for sudden infant death syndrome? J Pediatr 155:461-2
Thach, Bradley T (2008) Some aspects of clinical relevance in the maturation of respiratory control in infants. J Appl Physiol 104:1828-34
Thach, Bradley T (2007) Maturation of cough and other reflexes that protect the fetal and neonatal airway. Pulm Pharmacol Ther 20:365-70
Thompson, John M D; Thach, Bradley T; Becroft, David M O et al. (2006) Sudden infant death syndrome: risk factors for infants found face down differ from other SIDS cases. J Pediatr 149:630-633
Scheers-Masters, Joshua R; Schootman, Mario; Thach, Bradley T (2004) Heat stress and sudden infant death syndrome incidence: a United States population epidemiologic study. Pediatrics 113:e586-92
Paluszynska, Dorota A; Harris, Kathleen A; Thach, Bradley T (2004) Influence of sleep position experience on ability of prone-sleeping infants to escape from asphyxiating microenvironments by changing head position. Pediatrics 114:1634-9
Kahraman, Levent; Thach, Bradley T (2004) Inhibitory effects of hyperthermia on mechanisms involved in autoresuscitation from hypoxic apnea in mice: a model for thermal stress causing SIDS. J Appl Physiol 97:669-74

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