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:6/25/2016)... ... June 25, 2016 , ... Austin residents seeking Mohs ... College of Mohs Surgery and to Dr. Russell Peckham for medical and surgical dermatology. ... treatment for skin cancer. The selective fellowship in Mohs Micrographic Surgery completed by Dr. ...
(Date:6/25/2016)... City, Oklahoma (PRWEB) , ... June 25, 2016 ... ... helping both athletes and non-athletes recover from injury. Recently, he has implemented orthobiologic ... the Oklahoma City area —Johnson is one of the first doctors to perform ...
(Date:6/24/2016)... ... June 24, 2016 , ... June 19, 2016 is World Sickle Cell Observance ... and the benefits of holistic treatments, Serenity Recovery Center of Marne, Michigan, ... Disease. , Sickle Cell Disease (SCD) is a disorder of the red blood cells, ...
(Date:6/24/2016)... ... June 24, 2016 , ... Comfort Keepers® of San Diego, ... and the Road To Recovery® program to drive cancer patients to and from their ... to ensure the highest quality of life and ongoing independence. Getting to and ...
(Date:6/24/2016)... Las Vegas, Nevada (PRWEB) , ... June 24, ... ... their Las Vegas client, The Grove Investment Group (TGIG), has initiated cultivation and ... The Grove, in Las Vegas and Pahrump, Nevada. , Puradigm is the manufacturer ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... Capricor Therapeutics, Inc. ... company focused on the discovery, development and commercialization ... in its ongoing randomized HOPE-Duchenne clinical trial (Halt ... its 24-patient target. Capricor expects the trial to ... 2016, and to report top line data from ...
(Date:6/23/2016)... 2016  Astellas today announced the establishment of Astellas Farma Colombia (AFC), a new affiliate with operations headquartered in ... America . ... ... ... ...
(Date:6/23/2016)... 2016  Experian Health, the healthcare industry ... patient payment and care experience, today announced ... and services that will enhance the breadth ... These award-winning solutions will enable healthcare professionals ... in an ever-changing environment and redefine front-office ...
Breaking Medicine Technology: