Normal Fetal Hemoglobin Levels in the Sudden Infant Death Syndrome

H. Ronald Zielke, Robert G. Meny, M. john O'brien, John E. Smialek, Ferdane Kutlar, Titus H.j. Huisman, George J. Dover

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Abstract

It has been reported that infants who die of the sudden infant death syndrome (SIDS) have elevated fetal hemoglobin levels. To test this hypothesis, we determined the level of fetal hemoglobin in dead and living infants in three different laboratories by three methods: high-performance liquid chromatography, polyacrylamide-gel electrophoresis, and cell-based immunofluorescence assays for fetal hemoglobin-containing red cells (F cells). Our infant study population consisted of 67 infants who had died of SIDS, 22 control infants examined at autopsy, and 80 living infants. The fetal hemoglobin level was not higher in the infants who had died of SIDS than in the control infants for any age group analyzed. Immunofluorescence assays for F cells were also performed in blood samples from 105 mothers of infants who had died of SIDS, 55 adult female controls, 52 fathers of infants who had died of SIDS, and 67 adult male controls. The percentage of fetal hemoglobin–containing red cells in the parents of infants who had died of SIDS was not statistically different from that in sex-matched adults in the control groups. We conclude that elevated fetal hemoglobin levels in infants or their parents are not suitable for use as indicators of the risk of SIDS in the infants. Furthermore, the fetal hemoglobin level is not useful as a postmortem marker of an infant's having died of SIDS. SUDDEN infant death syndrome (SIDS) is the primary cause of death among infants between 1 and 12 months of age; it occurs most frequently between 2 and 4 months of age.1,2 The syndrome is diagnosed by the exclusion of other possible causes of death. Nevertheless, infants who die of SIDS have a higher frequency of several characteristics than infants who die of other causes1,2: evidence of brain-stem gliosis,3 4 5 retention of periadrenal brown fat,6 and hepatic erythropoiesis.7 Recently Giulian et al.8 reported a consistent elevation of the fetal hemoglobin level in infants who had died of SIDS. Earlier, Zielke and…

Original languageEnglish (US)
Pages (from-to)1359-1364
Number of pages6
JournalNew England Journal of Medicine
Volume321
Issue number20
DOIs
StatePublished - Nov 16 1989

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Fetal Hemoglobin
Sudden Infant Death
Fluorescent Antibody Technique
Cause of Death
Parents
Gliosis
Brown Adipose Tissue

ASJC Scopus subject areas

  • Medicine(all)

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Zielke, H. R., Meny, R. G., O'brien, M. J., Smialek, J. E., Kutlar, F., Huisman, T. H. J., & Dover, G. J. (1989). Normal Fetal Hemoglobin Levels in the Sudden Infant Death Syndrome. New England Journal of Medicine, 321(20), 1359-1364. https://doi.org/10.1056/NEJM198911163212003

Normal Fetal Hemoglobin Levels in the Sudden Infant Death Syndrome. / Zielke, H. Ronald; Meny, Robert G.; O'brien, M. john; Smialek, John E.; Kutlar, Ferdane; Huisman, Titus H.j.; Dover, George J.

In: New England Journal of Medicine, Vol. 321, No. 20, 16.11.1989, p. 1359-1364.

Research output: Contribution to journalArticle

Zielke, HR, Meny, RG, O'brien, MJ, Smialek, JE, Kutlar, F, Huisman, THJ & Dover, GJ 1989, 'Normal Fetal Hemoglobin Levels in the Sudden Infant Death Syndrome', New England Journal of Medicine, vol. 321, no. 20, pp. 1359-1364. https://doi.org/10.1056/NEJM198911163212003
Zielke HR, Meny RG, O'brien MJ, Smialek JE, Kutlar F, Huisman THJ et al. Normal Fetal Hemoglobin Levels in the Sudden Infant Death Syndrome. New England Journal of Medicine. 1989 Nov 16;321(20):1359-1364. https://doi.org/10.1056/NEJM198911163212003
Zielke, H. Ronald ; Meny, Robert G. ; O'brien, M. john ; Smialek, John E. ; Kutlar, Ferdane ; Huisman, Titus H.j. ; Dover, George J. / Normal Fetal Hemoglobin Levels in the Sudden Infant Death Syndrome. In: New England Journal of Medicine. 1989 ; Vol. 321, No. 20. pp. 1359-1364.
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