SYMPTOMS, SWEATING AND REACTIVITY OF INFANTS WHO DIE OF SIDS COMPAREDWITH COMMUNITY CONTROLS

Objective: To describe the symptoms of illness reported by the parents of infants who have died of sudden infant death syndrome (SIDS) compa red with those reported by community controls. Methodology: A nationwi de case-control study involving regions of New Zealand with 78% of all births between 1987 and 1990. Home interviews were completed with par ents of 393 (81% of total) infants who died from SIDS in the post neon atal age group, and 1592 (88.4% of total) controls who were a represen tative sample of all hospital births in the study region. Results: Sym ptoms of infection were common in both cases and controls, but were no t significantly different. infants dying of SIDS, however, were likely to have symptoms suggestive of more severe illness in the 2 days befo re death (odds ratio [OR] = 3.02, 95% confidence interval [CI] 1.69-5. 38). After adjusting for potential confounding this was still statisti cally significant (adjusted OR 2.36, 95% CI 1.14-4.90). Also, babies d ying of SIDS were more likely to have been less reactive to their envi ronment in the 2 weeks before death corn pared with the controls (univ ariate OR 0.88, 95% CI 0.55-1.39, adjusted OR 0.55, 95% Cl 0.29-0.88). 'Drenching' sweats at least weekly were reported for 15.6% of case in fants compared with 5.9% of control infants (adjusted OR 2.12, 95% CI 1.53-3.39). Forty per cent of these infants had this symptom in the fi rst 4 weeks of life when it was also associated with a significantly r aised risk of SIDS. Apnoea lasting more than 20 s was reported for 13. 2% of case infants compared with 5.3% of control infants (adjusted OR 1.93, 95% CI 1.17-3.17). Similarly, 71.8% of case infants' faces were reported to never turn red while awake compared to 49.8% of control in fants (adjusted OR 2.98, 95% CI 2.19-4.07). Conclusions: Only a smalt number (6.4%) of babies who die of SIDS have symptoms of serious illne ss in the 2 days before death. There is support for the hypothesis tha t there is a group of babies dying of SIDS who have subtle abnormaliti es in autonomic control or arousal ability.