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Scientists may have taken a step closer to uncovering the causes of Sudden Infant Death Syndrome in a study that has been hailed as a significant breakthrough by the British scientist whose work has supported the Back to Sleep campaign for years. 1990.

The study is the first to identify a biochemical marker in the blood that is linked to the risk of Sudden Infant Death Syndrome, sometimes called Sudden Infant Death Syndrome, when a seemingly healthy infant dies while sleeping. Although the test is not accurate enough to be used in newborn screening, it suggests that abnormally low levels of a chemical linked to the brain’s arousal system may be involved in the sudden death of these babies during their birth. sleep.

“This is a very important observation,” said Professor Peter Fleming, from the University of Bristol, whose work is credited with preventing tens of thousands of baby deaths in the UK after the Back to Sleep launched in the 1990s. “If it tells us something new about the mechanism, then it’s very important.”

The inquest was led by Dr Carmel Harrington, an honorary researcher at Westmead Children’s Hospital, New South Wales, who lost her own son, Damien, to Sids 29 years ago. Harrington and colleagues compared dried blood samples taken during the newborn heel prick test from 655 healthy babies, 26 babies who died of Sids and 41 babies who died in infancy of other causes.

They found that the Sids babies had lower levels of an enzyme called butyrylcholinesterase (BChE), which plays a major role in the brain’s excitatory pathway. This could indicate arousal deficit, which reduces an infant’s ability to wake up or respond to the outside environment, such as overheating or a covering over the face. This could make Sids vulnerable, the scientists said.

“Until now, we didn’t know what was causing the lack of excitement,” Harrington said. “Now that we know BChE is involved, we can start to change the fate of these babies and make Sids a thing of the past.

“A seemingly healthy baby who falls asleep and doesn’t wake up is every parent’s nightmare and until now there was absolutely no way of knowing which baby would succumb.”

However, at this stage, screening for BChE would not be useful as a neonatal screening tool. Although the baby Sids had lower levels on average, there was also a lot of overlap between the groups, with around half of the baby Sids falling in the same range as half of the babies who did not die.

The biomarker was also not as strong a predictor as some previously known environmental factors, such as smoking during pregnancy, which is linked to a more than three-fold increase in the incidence of Sids. Babies with low BChE had a 1.1 to 1.5 times higher risk of Sids.

“What worries me — and I’ve had calls from bereaved families before — is that at this point it’s not usable by the individual,” Fleming said. “It’s useful at the population level.”

The findings could help explain how smoking during pregnancy leads to biological changes that put babies at increased risk for Sids, for example. “It needs a lot more investigation,” Fleming said.

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Jenny Ward, chief executive of the Lullaby Trust, said: “The results of this study are exciting and there is still work to be done. We look forward to learning more as this research continues and hope it helps us better understand Sudden Infant Death Syndrome.

She added that it was important the results were not taken as a reason to downplay safer sleep advice, including “always sleep baby on their back in an unobstructed sleeping space on a flat, firm, waterproof mattress. without bedding, pillows or bumper.

The results are published in the Lancet eBioMedicine journal.

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