Sudden infant death and home monitors
R. G. Meny, L. Blackmon, D. Fleischmann, R. Gutberlet and E. Naumburg
Department of Pediatrics, University of Maryland School of Medicine, Baltimore.
During a two-year period, ten infants died suddenly and unexpectedly with a
home cardiorespiratory monitor available. We investigated the compliance
with appropriate monitoring technique as well as the medical and
demographic factors associated with these deaths (90% were due to sudden
infant death syndrome). At least six and probably eight of these ten
families were noncompliant with appropriate monitoring technique. The main
comparison group consisted of 211 patients for whom care with home
cardiorespiratory monitors was initiated and continued. Bronchopulmonary
dysplasia and severe, apparent life-threatening events were significantly
increased in the subjects, as were the following characteristics: black
race; lack of private medical insurance; unmarried mother; maternal age of
less than 25 years; cigarette smoking by mother during pregnancy; and low
Apgar scores. These diagnostic and demographic factors may be useful in
predicting the infant at highest risk for sudden and unexpected death when
a home monitor is prescribed. Noncompliance with proper monitoring
technique patients; methods of educating parents of infants at high risk of
sudden infant death syndrome with the necessity for compliance need to be
developed.
