Is shock a key element in the pathology of sudden infant death syndrome (SIDS)?

Journal Article (Journal Article)

In developed countries, sudden infant death syndrome (SIDS) is the most common cause of death for infants between 1 month and 1 year of age. The etiology of SIDS is likely to be multifactorial, and current paradigms often describe three overlapping elements of risk. Those elements are a critical developmental period, a vulnerable infant, and one or more exogenous stressors. In the triple-risk model, SIDS infants are described as having an underlying vulnerability in cardiorespiratory control in the central nervous system during a critical period when autonomic control is developing. This vulnerability might affect the response to exogenous stressors, including prone sleeping position, hypoxia, and increased carbon dioxide. In the common bacterial hypothesis and fatal triangle, the focus is on the stressors. In the first, a combination of common respiratory infections can cause SIDS in an infant during a developmentally vulnerable period. This theory also includes 3 factors of vulnerability: a genetic predisposition, a vulnerable developmental age, and infectious stressors. In the fatal triangle theory, infection, inflammation, and genetics each play a role in triggering a SIDS fatality. From our work in an animal model, we have found that rat pups die from a combination of infectious insults during a critical time of development. This is exacerbated by perinatal nicotine exposure, a condition shown to alter the autonomic response in exposed offspring. We are proposing that shock and cardiovascular collapse is a key element that links these theories.

Full Text

Duke Authors

Cited Authors

  • Blood-Siegfried, J; Bowers, MT; Lorimer, M

Published Date

  • October 2009

Published In

Volume / Issue

  • 11 / 2

Start / End Page

  • 187 - 194

PubMed ID

  • 19114412

Pubmed Central ID

  • PMC2989240

Electronic International Standard Serial Number (EISSN)

  • 1552-4175

International Standard Serial Number (ISSN)

  • 1099-8004

Digital Object Identifier (DOI)

  • 10.1177/1099800408324854


  • eng