Experts Caution Interpretation of Recent Popular SIDS Study
Photo by Louis Reed on Unsplash
A recently-released SIDS study (May 6, 2022) has received exceptional media attention, having indicated a possible blood protein link that may be implicated in why some babies do not startle and arouse when breathing stops. However, as this was a small study using blood samples that were more than two years old, many experts are urging caution in interpreting the results, and the study leads, Carmel Harrington and Karen Waters, stress that much more research would be needed, saying their “finding represents the possibility for the future identification of infants at risk for SIDS” with the study identifying “a measurable biochemical marker (not cause)” of the condition.
A Global News headline on May 14, 2022, leads with the headline, “Researchers say they’ve found the reason why infants die from SIDS.” However, the article goes on to outline that many experts in the field are concerned that the excitement is coming too early. The small study, using blood samples taken from perinatal heel pricks, represents only a potentially hopeful starting point for further research.
The article quotes Jenny Ward, the chief executive of the Lullaby Trust, who told The Guardian that it is important that caregivers continue to follow safe sleeping advice.
The Public Health Agency of Canada (PHAC), in partnership with other Canadian health organizations, recommends a number of sleep safety practices including:
Put infants down on their backs to sleep, in their own crib or bassinet.
Prevent exposure to tobacco smoke before and after birth.
Avoid bed-sharing.
Avoid overheating.
Remove toys and soft bedding from sleeping surfaces.
Benjamin Mazer, a hospital pathologist specializing in diagnostic testing, writing in The Atlantic, notes, “At best, the study represents an incremental advance. This is not meant to be an insult; science works in increments. But the numbers don’t suggest that a screening test for SIDS is really in the works, let alone one that will quickly end the scourge of infant deaths. The authors report that protein-activity levels were measured in a range of 1.7 to 23.3 units per milligram for healthy newborns, and from 2.9 to 10.8 for those who died of SIDS. Though the group averages were different overall (7.7 versus 5.6) individual values still overlapped a great deal. In other words, a low protein-activity level at birth could be found in a baby who might end up dying from SIDS, as well as one who would go on to live a healthy life.”
Mazer expresses concern that “the confusing and controversial status of SIDS as a formal diagnosis adds to the uncertainty. SIDS is considered a “diagnosis of exclusion,” which means that it applies only when other causes have been carefully ruled out, and also that it is likely to comprise a number of different conditions…The authors of this month’s study did not have access to autopsy details for any of their subjects, and relied in most cases on a coroner’s assessment that SIDS had been the cause of death.”
Mazer’s experience in the diagnostic testing he performs in his work as a pathologist also leads him to think that “even if it were possible to develop a screening test for SIDS, we might not want to use it…I know that every form of screening makes mistakes. Sometimes [e.g. in cervical-cancer screening] the benefits from these tools are worth the harm of an occasional error.” His fear is that “a wonky SIDS test would have catastrophic ill effects. A false positive result would terrify new parents. A false negative could lead them to abandon safe-sleeping practices – or far worse, make them seem at fault if SIDS did strike. Even true results might not be much help, because early-detection tests are only as good as the treatments we use in response to them.”
Karen Waters, in an email to Mazer, noted, “As we said in the paper, it offers new directions for research in the field,” and her co-researcher, Carmel Harrington, who initially became interested in researching SIDS after losing a child herself and having the doctors be unable to explain her son’s death, stated that “this finding is only one bit of the puzzle and there is so much more to learn.”