NEWBORN ACOUSTIC CRY CHARACTERISTICS OF INFANTS SUBSEQUENTLY DYING OFSUDDEN-INFANT-DEATH-SYNDROME

Objective. To test the hypothesis that the occurrence of a neonatal cr y exhibiting a high first formant is a risk factor for sudden infant d eath syndrome (SIDS) and to evaluate the association between SIDS and other acoustic cry variables. Method. We recorded cries and obtained m edical and demographic data for 21880 apparently healthy term newborns . Two cries were recorded between days 2 and 7 of life, after a painfu l stimulus at the time of routine blood drawing. Acoustic variables we re measured with an automated computer-based analysis system. Twelve i nfants died of SIDS. Age at death ranged from 19 days to 6.5 months. A utopsies were performed in all cases. At least one cry was analyzed fo r all 12 infants who died of SIDS and 20167 infants without SIDS. Two cries were analyzed for 9 infants who died of SIDS and 14235 infants w ithout SIDS. Results. Newborns whose first cries exhibited a high firs t formant were more likely to die of SIDS than infants whose first cri es did not have this characteristic (relative risk, 3.5; 95% confidenc e interval [CI], 1.1 to 12). The relative risk for SIDS increased to 8 .8 (95% CI, 2.2 to 35) for newborns whose second cries showed that thi s characteristic persisted. Newborns with the combination of both a hi gh first formant and a high number of mode changes on both of two crie s had a relative risk of 32 (95% CI, 8.7 to 120). Conclusions. We have shown an association between alterations in neonatal cry acoustics an d SIDS. Cry analysis represents a potentially important research tool that, when studied in relation to other physiologic measures, may lead to an improved understanding of SIDS.