a unifying theory for sidssids的统一理论.pdfVIP

Hindawi Publishing Corporation International Journal of Pediatrics Volume 2009, Article ID 368270, 10 pages doi:10.1155/2009/368270 Review Article A Unifying Theory for SIDS David T. Mage1 and Maria Donner2 1A. I. duPont Hospital for Children, Biomolecular Core Laboratory, 1600 Rockland Road, Wilmington, DE 19803, USA 2 DuPont Haskell Global Centers for Health Environmental Sciences, Investigative Sciences, Newark, DE 19711, USA Correspondence should be addressed to David T. Mage, magedonner@ Received 8 May 2009; Revised 22 July 2009; Accepted 23 July 2009 Recommended by Edward F. Donovan The Sudden Infant Death Syndrome (SIDS) has four distinctive characteristics that must be explained by any theory proposed for it. (1) A characteristic male fraction of approximately 0.61 for all postneonatal SIDS in the US; (2) a distinctive lognormal-type age distribution arising from zero at birth, mode at about 2 months, median at about 3 months, and an exponential decrease with age going towards zero beyond one year; (3) a marked decrease in SIDS rate from the discovery that changing the recommended infant sleep position from prone to supine reduced the rate of SIDS, but it did not change the form of the age or gender distributions cited above; (4) a seasonal variation, maximal in winter and minimal in summer, that implies subsets of SIDS displaying evidence of seasonal low-grade respiratory infection and nonseasonal neurological prematurity. A quadruple-risk model is presented that fits these conditions but requires confirmatory testing by finding a dominant X-linked allele protective against cerebral anoxia that is missing in SIDS. Copyright © 2009 D. T. Mage and M. Donner. This is an open access article distributed under the Creative Commons Attribution License, which p