Navigation Links
New Analysis Puts Cot Death Under Scrutiny Once Again

An analysis published in this weeks BMJ is set to re-open the debate over sudden unexpected infant death (cot death).

The Lancet recently published a study on repeat infant deaths in 46 families, which suggested that almost 90% of second deaths in the same family are natural.

These findings contrasted with earlier studies, which found a much higher proportion of repeat cot deaths were probably homicide. Yet the Lancet study has proved very influential, being accepted by bodies such as the American Academy of Pediatrics.

In December 2006, the BMJ questioned the way these deaths were classified in the study.

Today the BMJ publishes a re-analysis of the data by two senior (now retired) paediatricians, Christopher Bacon and Edmund Hey. They reviewed the 46 second deaths in the original study to see how many might reasonably be regarded as undetermined.

They suggest that, in the three families in the original study in which both deaths were attributed to specific natural causes, one death should be regarded as undetermined.

In 18 families in the original study, both deaths were attributed to sudden infant death syndrome. The authors stated that all these families were at high risk of cot death and that the second deaths exhibited many untoward features, such as violent family relationships, pathology findings suggestive of asphyxia, and parental mental health problems.

Although Bacon and Hey do not suggest that violence in the family, for example, necessarily implies that a babys death was unnatural, they believe that when a family has two unexplained deaths this possibility at least has to be considered and may sometimes be true. They therefore estimate that a third of these deaths might be classed as undetermined.

For 13 families in the study, information on the second death was incomplete. The original authors classified all these cases as natural, though they acknowledged that the information was insufficient to enable them to distinguish between sudden infant death syndrome and a specific natural cause.

But Bacon and Hey argue that it seems illogical to exclude covert homicide when there is not enough information to exclude a specific natural cause. They categorise all 13 cases as undetermined.

There were six further cases that could not be reviewed because the Lancet paper gave no details about them.

Overall, the re-analysis of these second deaths categorises 13% as probably unnatural, 43% as probably natural (although this includes the six cases they could not review) and 43% as undetermined. This contrasts with the original study that 87% of the deaths were natural, but is closer to the findings of previous studies that suggested about two fifths of repeat deaths probably resulted from homicide.

Bacon and Hey stress that their purpose is not to second guess the original authors, but they argue that using a dichotomy of natural or unnatural is unhelpful and more likely to be erroneous. They acknowledge the papers value in helping to avert unjustified suspicion of parents, but they are concerned that it may also lead to mistakes in child protection.

Uncertainty may be uncomfortable, they add, but it is truer to reality, more conducive to scientific inquiry, and safer for children than a dogmatic stance at either pole.

We would encourage professionals to keep an open mind in assessing unexplained infant deaths, to be aware of the difficulties in diagnosis, and to try to keep a balance between the need to support parents and the need to protect children, they conclude.


'"/>




Related medicine news :

1. Indian Scientists Make Wide-Ranging Analysis And Annotation Of X Chromosome
2. Meta Analysis Links Diabetes And Colorectal Cancer
3. NASA Analysis Say 2005 Was The Warmest Year
4. First Suspected Bird Flu Case In Serbia: Samples Sent For Analysis
5. A Detail Analysis of Head and Neck Cancer
6. Analysis: Bowel Diseases Triples Infertility Risks In Women
7. Analysis of Placenta Helps In Diagnosis of Autism At Birth
8. Analysis Shows Lamictal As An Effective Additional Therapy For Treatment of Grand Mal Seizures
9. Salivary Analysis for Early Detection of Breast Cancer
10. Severe Complications of Circumcision: An Analysis of 48 Cases
11. Newspaper Analysis positive Results for Organ Transplantation
Post Your Comments:
*Name:
*Comment:
*Email:


(Date:2/8/2016)... ... 08, 2016 , ... Stephanie Hebert Insurance Agency, serving families ... new charity campaign. As part of their ongoing community involvement program, funds are ... that children deserve a voice, and in the spirit of neighbors helping neighbors ...
(Date:2/8/2016)... ... 2016 , ... Tingley Rubber Corporation , a leading ... range of unique and advantaged protective solutions to a growing and dynamic ... customer service and marketing support. A new distribution center in Brampton, Ontario will ...
(Date:2/8/2016)... ... February 08, 2016 , ... ... networking and relationship-marketing firm, announced today that nominations will be accepted February ... (ISE®) West Awards. , Awards include the Information Security Executive® of ...
(Date:2/8/2016)... ... 2016 , ... GrassrootsHealth published data from its D*action public ... in the GrassrootsHealth cohort with substantially higher vitamin D levels than a cohort ... states Carole Baggerly, Director of GrassrootsHealth, “the safety and benefits of vitamin ...
(Date:2/8/2016)... (PRWEB) , ... February 08, 2016 , ... The ... annually in this country. The AutismOne 2016 Conference, which is being held May 25-29 ... often won’t hear elsewhere about helpful interventions and causes of chronic illness in children. ...
Breaking Medicine News(10 mins):
(Date:2/8/2016)... 2016 http://www.researchandmarkets.com/research/fqx6nz/global_skin ) ... Skin Protective Equipment Market 2016-2020" report to ... ) has announced the addition of the ... to their offering. --> ... the addition of the "Global Skin Protective ...
(Date:2/8/2016)... , Feb. 8, 2016  A research team ... scientists has discovered details of how the abnormal breakage ... a particularly aggressive form of acute lymphoblastic leukemia (ALL). ... which genetic mutations trigger overproduction of immature cells, called ... The discoveries of the malfunction underlying the type called ...
(Date:2/8/2016)... -- As part of a major growth and expansion initiative, Dune ... Lori Chmura as President of Dune Inc., its U.S. ... extensive experience in the medical device space will play a ... --> --> In her ... marketing and operational functions in the U.S. She is tasked ...
Breaking Medicine Technology: