Maternal and Child Health Library

MCH Alert: Focus on Infant Mortality is developed by the Maternal and Child Health Library in collaboration with the National Sudden and Unexpected Infant/Child and Pregnancy Loss Resource Center at Georgetown University. This and past issues are available online at http://www.mchlibrary.info/alert/archives.html and http://www.sidscenter.org/alert/archives.html.

August 28, 2009

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Special Notices:

In recognition of National Infant Mortality Awareness Month (September 2009), the National Healthy Start Association has produced a toolkit to help Healthy Start projects promote the effectiveness of programs and efforts to reduce infant deaths, low birthweight, preterm births, and disparities in perinatal outcomes. The toolkit is available at http://www.healthystartassoc.org/Toolkit.pdf. Additional information and resources are available from the Office of Minority Health's campaign, A Healthy Baby Begins with You, at http://www.omhrc.gov/templates/browse.aspx?lvl=2&lvlid=117

FINAL CALL: If you have not yet completed the 2009 MCH Alert Reader Feedback Form, please take a few moments to answer the questions and submit your comments at https://www.surveymonkey.com/s.aspx?sm=16ZJG5kXZgVQC_2bHc_2bxFH6A_3d_3d

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1. NATIONAL CENTER COMPILES RESOURCES ON THE TOPICS OF BEDSHARING AND CO-SLEEPING, SWADDLING, AND SHAKEN BABY SYNDROME

The National Sudden and Unexpected Infant-Child Death and Pregnancy Loss Resource Center's Web site includes an updated bibliography on bed sharing, co-sleeping, and sudden infant death syndrome (SIDS) and one on swaddling and SIDS. Each bibliography presents definitions and lists recent citations and abstracts from peer-reviewed journals. The bibliographies also include a customized tool that can be used to search PubMed for additional articles. The bibliographies are available as follows:

• Bed Sharing, Co-Sleeping, and Sudden Infant Death Syndrome (SIDS): A Selected Annotated Bibliography is available at http://www.sidscenter.org/TopicalBib/BedSharing.html
• Swaddling and Sudden Infant Death Syndrome (SIDS): A Selected Annotated Bibliography is available at http://www.sidscenter.org/TopicalBib/Swaddling.html

The Center's Web site also features a new A-Z Topics section: Shaken Baby Syndrome (Abusive Head Trauma). Contents include selected resources from the National Center on Shaken Baby Syndrome, the Colorado Prevention Campaign, MedlinePlus, KidsHealth from Nemours, and the National Institute of Neurological Disorders. The section is available at http://www.sidscenter.org/AZtopics/S.html#s6

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• Risk-reduction recommendations include putting infants to bed in the supine position on a firm mattress, preferably with a pacifier (mechanism unknown) and in a shared room (but in a separate bed).
• Important counseling strategies for families with infants who have died of SIDS have been devised. Of major concern in such families is the risk of SIDS in subsequent siblings. Although in such cases there is an increase in risk, it is minimal.

• Thirty-seven percent of the infants and children (N=1,803) fulfilled the study definition of shock at index 1, index 2, or both.
• The mortality rate was highest in infants and children with shock, regardless of trauma status: 28.3 percent in trauma infants and children with shock compared with 1.2 percent in those without shock and 10.5 percent in nontrauma infants and children with shock compared with 2.8 percent in those without shock.
• Early reversal of shock in the community hospital emergency department was associated with reduced mortality (5.06 percent vs. 16.37 percent) and functional morbidity rates (1.56 percent vs. 4.11 percent).
• Early use of therapies consistent with PALS-APLS-recommended guidelines in the community hospital emergency department was associated with a decrease in the shock index (heart rate and systolic blood pressure).
• Community hospital-emergency department delivery of therapy consistent with PALS-APLS recommendations was associated with a reduction in mortality (8.69 percent vs. 15.01 percent) and functional morbidity (1.24 percent vs. 4.23 percent) rates.
• Early implementation of PALS-APLS therapy remained associated with reduced mortality and functional morbidity rates after controlling for center, trauma status, and severity of illness.

• For women, NC resulted in accelerated resolution of depression, compared with SC and CC.
• For men, compared with SC and CC, there was substantial evidence that NC hastened resolution of depression.
• For women, compared with CC, both NC and SC provided weak evidence of hastening PG resolution of grief-related emotions.
• For men, compared with SC, both CC and NC offered strong evidence of accelerating resolution of pure grief and substantial to strong evidence of hastening men's resolution of grief-related emotions.
• There was no evidence to suggest that SC, CC, or control was more effective than NC in hastening men's or women's resolution of pure grief, grief-related emotions, or depression.