Study: Metabolic markers at birth may predict risk for sudden infant death syndrome
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Key takeaways:
- Inadequate prenatal care was associated with 3 times higher odds for SIDS.
- Among infants with a predicted probability higher than 0.5, 62.5% had SIDS.
Researchers identified metabolic markers from routine newborn screenings that were associated with sudden infant death syndrome and built a model that could predict the probability of SIDS, according to a study published in JAMA Pediatrics.
“The objective of this study was to evaluate the relationship between SIDS and metabolic markers routinely measured by newborn screening in combination with previously identified risk factors for SIDS,” Scott P. Oltman, MS, an epidemiologist for the California Preterm Birth Initiative at the University of California, San Francisco, and colleagues wrote.
The case-control study included 354 infants (62.1% boys; mean gestational age, 38.3 weeks; standard deviation [SD], 2.3 weeks) with SIDS listed as the cause of death. Oltman and colleagues used data from the California Office of Statewide Health Planning and Development for all births from January 2005 to December 2011. Each SIDS death was matched to four infants who survived their first year.
The largest proportion of infants with SIDS were Hispanic (41.2%) or non-Hispanic white (29.7%). The rest were Black (9.6%), Asian (9.3%) or other races or ethnicities (10.2%).
In a multivariable analysis, the variables with the strongest association with SIDS were inadequate prenatal care (OR = 3.13; 95% CI, 2.02-4.86), free carnitine (OR = 2.85; 95% CI, 1.73-4.7) and alanine (OR = 0.23; 95% CI, 0.13-0.42).
The researchers built a model to predict the probability of SIDS based on 14 variables, including eight metabolites like alanine and free carnitine, as well as clinical characteristics.
The area under the receiver operating characteristic curve for the full model in testing was 0.7 (95% CI, 0.65-0.76), and the eight metabolites alone was 0.63 (95% CI, 0.58-0.68).
There were 32 infants with a predicted probability higher than 0.5, of which 20 (62.5%) had SIDS, equating to 14 times higher odds compared with infants with a probability lower than 0.1 (OR = 14.4; 95% CI, 6-34.5).
“These findings suggest that metabolic profiles at birth may have utility for individualized, targeted counseling aimed at identifying infants with an increased vulnerability to SIDS,” the researchers wrote. “Further, these patterns point to novel inroads for scientists and clinicians to further investigate mechanisms of aberrant metabolites in SIDS in order to develop targeted therapeutics.”
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