Zeitschrift für Neonatalbiologie

Abstrakt

Italian National Database on Stillbirths versus Sudden Infant Death Syndrome (SIDS) – a new epidemiological and pathological perspective

Luigi Matturri, Anna Maria Lavezzi and Giuseppe Del Corno

Objective: To contribute to the epidemiological assessment of the risk factors underlying unexplained fetal death and sudden infant death, as required by Italian Law 31/2006, and to a more balanced assessment of the morphological substrates of these everyday occurrences.

Methods: 59 cases of sudden fetal death and 61 cases of SIDS were compared with 120 matched controls randomly selected from live-born children of mothers living in the same catchment area to determine whether one or more exogenous variables could contribute to unexpected death. Anatomical-pathological studies were subsequently performed on the autonomic nervous and cardiac conduction systems of the deceased victims.

Results: Preterm birth and maternal smoking are critical factors for infant mortality. In particular, mothers who smoked during pregnancy had twice the risk of sudden fetal death and SIDS compared to mothers who never smoked. In addition, the location and nature of a number of specific congenital anomalies of the autonomic nervous system and cardiac conduction system were highlighted as morphological substrates of the pathophysiological mechanism of unexpected death.

Conclusion: Smoking during pregnancy is associated with a significantly increased risk of unexpected fetal mortality and sudden infant death. Therefore, it is important to conduct information campaigns to reduce tobacco consumption, especially among young women.