July 1987

Screening of Subsequent Siblings of Children Who Die of [ill]Sudden Infant Death Syndrome

Author Affiliations

From the Department of Pediatrics, Isaac Walton Killam Hospital for Children, Halifax, Nova Scotia.

Am J Dis Child. 1987;141(7):807-810. doi:10.1001/archpedi.1987.04460070109037

• Since the value of home apnea monibring for subsequent siblings (subsibs) [ill]f an infant who died of sudden infant [ill]eath syndrome is uncertain, we de[ill]cribe an evaluation and monitoring pro[ill]ram for subsibs. Eighty subsibs were [ill]creened in hospital at an average age of [ill].6 weeks. The most valuable investiga[ill]ions included history, physical ex[ill]mination, blood gas tests, and four [ill[days on an apnea monitor in hospital. [ill]sleep recordings added no decision[ill]aking data. Only 23 infants met one of [ill]he following criteria for home apnea [ill]onitoring: (1) sleep apnea for more [ill]han 15 s (either on sleep recording or [ill]ecognized by apnea alarm), (2) more [ill]han 4.5 episodes of apnea per hour of [ill]sleep (3) periodic breathing greater than [ill]24% of sleep time, or (4) severe parental anxiety. Twenty-two infants were moni[ill]tored until they were aged months and [ill]had spent two months apnea free. [ill]Twelve had apnea at home. All of the [ill]infants survived. Excessive periodic breathing alone did not seem to be a valid reason for home monitoring. Our screening program is simple, acceptable to families, and useful to select a smaller number of subsibs for home apnea monitoring.

(AJDC 1987;141:807-810)