Existing newborn screenings may be able to identify risk of sudden infant death syndrome, study finds

It’s a tragedy with few answers: Sudden infant death syndrome represents the highest incidence of deaths per thousand of infants aged between one month and one year depending on the region in the U. S. 
 
Born apparently healthy, affected children usually die suddenly for no apparent reason, and mostly while asleep. The CDC estimated that 1,378 infants passed away in 2020 because of SIDS, as that condition is informally referred to — the most recent year for which data is available. 
 
At present, there is no way of predicting that a baby could be at risk of having SIDS later in the future. However, a fresh research has revealed that there are certain chemicals known as the metabolites, which when tested as common newborn screening tests, can help spot the babies at greater risk. 
 
The “heel stick” test is required for new-borns in all the States of America and involves pricking the baby’s heel to get a blood sample after the birth. That is used for diagnosis of diseases such as sickle cell disease through some markers in the blood sample. 
 
The metabolites that were discovered to be linked to SIDS are eight in number and they form the newborn screening panel as revealed in the new study that was done and published in the JAMA Pediatrics on Monday. These are produced in the course of metabolism of nutrients in the body. 
 
The results showed that the probability of SIDS in children relationships with specific levels of these metabolites in blood increased and reached 14 times in comparison with the least dangerous level. 
 
Writing about the findings, one of the study’s authors, Laura Jelliffe-Pawlowski from New York University, said: “We conclude that the risk of getting a true positive for sudden death: is higher for babies who metabolically differ from their Dutch peers. ” 
 
The research was conducted by Figueroa Jelliffe-Pawlowski when she was affiliated to the University of California San Francisco as an epidemiology and biostatistics professor. 
 
She said the screenings allowed the identification of the so-called ‘very low risk’ children, meaning that they are not zero risk, … ‘very high risk’ for SIDS and which requires more attention. 
 
The results presented derive from infants born in California born between 2005 and 2011. The researchers contrasted screening tests of 354 infants who died from SIDS with 1,416 infants who were SIDS free. To remove the effects outside factors could have on a baby, risks were put through a statistical model to isolate them balancing factors such as mother’s age, race or health. 
 
Jelliffe-Pawlowski noted that data in the study show that the infants who are at possible higher risk for SIDS might have some issues in using and metabolizing sugars or fats. 
 
“Maybe we’re looking at some food sensitivities,” she said, but noted that there will be a long way needed to go to understand the association between metabolism and SIDS risk. “At the moment it is difficult to know what will happen. ” 
 
In any case, even if additional research demonstrates that certain metabolic abnormalities are indeed a risk factor, the real question is what to do if one or more appear on the list of the newborn’s screening results. In most cases, SIDS is very hard to prevent. 
 
“I worry a little bit about what this could do to stress and anxiety, if we say, ‘Hey, my kid’s at an increased odds for this, but there’s nothing I can do,’” said Dr. Stephanie Napolitano, a neonatology physician at Nationwide Children’s Hospital who was not involved in the new study. 
 
Laying the baby on his or her back to sleep as well as ensuring that the room is not too hot are recommendations parents can implement but those two approaches are not enough. 
 
Such suggestions raised doubts about whether newborn screenings can offer sufficient answers, according to Dr. Joanna Parga-Belinkie, a neonatologist at Children’s Hospital of Philadelphia who wasn’t involved in the work. 
 
“It’s probably that newborn screening for that matter is not going to be sensitive or specific enough to be a good screen for SIDS,” she said, and at best, it will only inform the doctors that they need to look for further tests in babies that have an abnormal metabolic screen. 
 
Scientists believe that SIDS is caused by more than one factor but by fewer than five. It will be more probable if it occurs when the baby is at a sensitive age and therefore is susceptible to many things and when they are exposed to some form of stress such as sleeping in the prone position this could lead to low oxygen and high carbon monoxide in the body. Experts also believe that some underlying pathology may exist, this may be genetic, metabolic or neurological disorders. 
 
The new study ‘doesn’t rule out the potential that there is some genetic event’, said Dr Debra Weese-Mayer, chief of the pediatric autonomic medicine division at the Lurie Children’s Hospital of Chicago and who was not involved in the research. 
 
“But every baby that’s born isn’t going to get a deep-dive genetic evaluation — they do get newborn screenings,” she added. 
 
There are now other SIDS risk factors that have been identified in some recent SIDS research; some of them are serotonin, which plays a role in controlling heart rate and breathing. A study last year found that modified one of the receptors involved in the serotonin system could help some infants avoid temporarily stopping breathing when they struggle to get enough oxygen while sleeping. 
 
A research in 2022, however, implies that the infants who died SIDS had reduced production of a chemical messenger associated with portion of the nervous system, autosomal, responsible for managing functions such as heartbeat and respiration without any control from the brain. 
 
Scientists noted that it is even premature to conclude that metabolic variation detected in the new study is connected to neurological variation found in prior studies. 
 
“Your body works just like this,” Napolitano went on: “Your autonomic nervous system must have an influence and part in your metabolism. ” “As for how all of those pieces fit together, that is still a problem. ”