PEDIATRICS Vol. 77 No. 4 April 1986, pp. 451-458
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Sudden Infant Death Syndrome in Infants Evaluated by Apnea Programs in California

Sally L. Davidson Ward MD1, Thomas G. Keens MD1, Linda S. Chan PhD1, Bradley E. Chipps MD1, Stephen H. Carson MD1, Douglas D. Deming MD1, Vijaya Krishna MD1, Hugh M. MacDonald MD1, Gilbert I. Martin MD1, Keith S. Meredith MD1, T. Allen Merritt MD1, Bruce G. Nickerson MD1, Ronald A. Stoddard MD1, and Andre L. van der Hal MD1

1 From the Childrens Hospital of Los Angeles and University of Southern California School of Medicine, Los Angeles, San Diego, Sacramento, Loma Linda, Oakland, Van Nuys, and Travis Air Force Base

Home apnea/bradycardia monitoring is frequently used in the management of infants at increased risk for sudden infant death syndrome (SIDS). However, some infants have died despite evaluation by infant apnea programs, and the benefits of home monitoring remain unproven. To determine the SIDS rate and risk factors of infants evaluated by infant apnea programs, 31 apnea programs and ten home monitor vendors in California were surveyed. Eleven (35%) of the apnea programs and four (40%) of the vendors responded. Information was obtained on 26 infants who died. Thirteen (50%) deaths were due to SIDS. Abnormal sleep studies did not predict death. Fifteen infants died despite a recommendation for home monitoring. Seven deaths occurred in association with technical errors or noncompliance with monitoring. Four deaths were due to nonaccidental trauma. The apnea programs evaluated 3,406 infants during a 5-year period; 1,841 had monitoring recommended. Term infants with apnea, subsequent siblings of SIDS victims, and infants evaluated at referral centers were more likely to have monitoring recommended than premature infants with apnea or infants evaluated at nonreferral centers (P < .0001). Infants who had monitoring recommended were at equal risk of dying of SIDS as those who did not.

Key Words: sudden infant death syndrome • home monitoring • infant apnea • apnea of prematurity • sibling

Submitted on July 1, 1985


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