The long-term objectives of this proposal are to elucidate physiologic mechanisms that underlie the Sudden Infant Death Syndrome, and to develop age-appropriate, non-invasive tests that will identify infants who are at the greatest risk for SIDS. These tests focus on assessments of peripheral and central mechanisms involved in the integrated control of cardiac, blood pressure, and respiratory function. Subjects are the fetuses and infants of mothers from a low-socioeconomic status population in New York City and from a rural Native American population on the Pine Ridge Reservation in South Dakota, which is at unusually high risk for SIDS. The proposed studies begin with measurements made during late gestation. Assessments then continue through infancy to document the physiologic changes that coincide with the period of maximal risk for SIDS. These postnatal studies incorporate measurements made during sleep under basal conditions as well as during head-up and head-down tilting. The principal dependent variables are heart rate and several indices of heart rate variability, respiratory rate and variability, body temperature, and electrocortical activity and beat-to-beat blood pressure. Five experiments will address the following aims; Patterns of developmental change in cardiorespiratory activity measured from the late fetal period through infancy will distinguish groups of infants at increased risk for SIDS How postnatal development of heart rate, blood pressure and respiratory responses to the challenge of head-up and head-down tilting will be altered in groups of infants at increased risk for SIDS Physiologic responses to tilt are dependent upon sleep state and this dependency may change with age Blood pressure decreases to head-up tilt are larger in the prone sleeping position Head-up tilting will induce cortical activation which will be diminished during the period of greatest vulnerability to SIDS Respiratory and heart rate responses to tilt will be diminished in the morning hours and Responses to tilt will vary with time after feeding.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
2R01HD032774-05A1
Application #
2907416
Study Section
Human Development and Aging Subcommittee 3 (HUD)
Program Officer
Willinger, Marian
Project Start
1994-09-30
Project End
2004-04-30
Budget Start
1999-05-01
Budget End
2000-04-30
Support Year
5
Fiscal Year
1999
Total Cost
Indirect Cost
Name
New York State Psychiatric Institute
Department
Type
DUNS #
167204994
City
New York
State
NY
Country
United States
Zip Code
10032
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Isler, Joseph R; Grose-Fifer, Jillian; Fifer, William P et al. (2007) Frequency domain analyses of neonatal flash VEP. Pediatr Res 62:581-5
Fifer, William P; Myers, Michael M; Sahni, Rakesh et al. (2005) Interactions between sleeping position and feeding on cardiorespiratory activity in preterm infants. Dev Psychobiol 47:288-96
Sahni, R; Schulze, K F; Kashyap, S et al. (2005) Sleeping position and electrocortical activity in low birthweight infants. Arch Dis Child Fetal Neonatal Ed 90:F311-5
Kinney, Hannah C; Myers, Michael M; Belliveau, Richard A et al. (2005) Subtle autonomic and respiratory dysfunction in sudden infant death syndrome associated with serotonergic brainstem abnormalities: a case report. J Neuropathol Exp Neurol 64:689-94
Grieve, Philip G; Myers, Michael M; Stark, Raymond I et al. (2005) Topographic localization of electrocortical activation in newborn and two- to four-month-old infants in response to head-up tilting. Acta Paediatr 94:1756-63

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