Neuropathology of Early Sudden Infant Death Syndrome—Hypoplasia of the Pontine Kolliker-Fuse Nucleus: A Possible Marker of Unexpected Collapse during Skin-to-Skin Care

Anna M. Lavezzi; Stefano Ferrero; Beatrice Paradiso; Liliya Chamitava; Francesco Piscioli; Teresa Pusiol

doi:10.1055/s-0038-1669398

American Journal of Perinatology, Table of Contents

Am J Perinatol 2019; 36(05): 460-471
DOI: 10.1055/s-0038-1669398

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Neuropathology of Early Sudden Infant Death Syndrome—Hypoplasia of the Pontine Kolliker-Fuse Nucleus: A Possible Marker of Unexpected Collapse during Skin-to-Skin Care

Anna M. Lavezzi

¹Department of Biomedical, Surgical and Dental Sciences, “Lino Rossi” Research Center for the Study and Prevention of Unexpected Perinatal Death and SIDS, University of Milan, Milan, Italy

,

Stefano Ferrero

¹Department of Biomedical, Surgical and Dental Sciences, “Lino Rossi” Research Center for the Study and Prevention of Unexpected Perinatal Death and SIDS, University of Milan, Milan, Italy

²Division of Pathology, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy

,

Beatrice Paradiso

¹Department of Biomedical, Surgical and Dental Sciences, “Lino Rossi” Research Center for the Study and Prevention of Unexpected Perinatal Death and SIDS, University of Milan, Milan, Italy

³Cardiovascular Pathology Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy

,

Liliya Chamitava

⁴Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy

,

Francesco Piscioli

⁵Institute of Pathology, Hospital of Rovereto, Trento, Italy

,

Teresa Pusiol

⁵Institute of Pathology, Hospital of Rovereto, Trento, Italy

› Author Affiliations

Abstract

Objective To find a possible pathogenetic mechanism of the early sudden infant death occurring in newborns during the skin-to-skin care (SSC), through the examination of neuronal centers regulating the vital activities.

Study Design This is an in-depth examination of the brain stem in 22 healthy term newborns, suddenly died in the first hour of life without the identification of a cause at autopsy (early sudden infant death syndrome [eSIDS]), 12 of them concomitantly with SSC, and 10 with age-matched controls died of known pathology.

Results Developmental alterations of neuronal structures of the brain stem were highlighted in 19 of the 22 eSIDS, but not in control. The hypoplasia of the pontine Kölliker-Fuse nucleus (KFN), an important respiratory center, was diagnosed at the histological examination, validated by morphometric quantifications, in 11 of the 12 eSIDS while they were placed on the mother's chest and in 2 of the 10 SSC unrelated neonatal deaths.

Conclusion The delayed development of the KFN could represent a specific finding of eSIDS occurring during SSC. Therefore, it is necessary to point out that the SSC represents a further risk factor that must be added to others already known for sudden infant death syndrome. Then this practice needs appropriate monitoring strategies of the infant's conditions.

Keywords

skin-to-skin care - sudden unexpected postnatal collapse - sudden infant death syndrome - early sudden infant death syndrome - risk factors - neuropathology - brain stem - Kölliker-Fuse nucleus

Full Text

References

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