Is butyrylcholinesterase a potential biomarker for sudden infant death syndrome’s prevention?: a pilot, retrospective, case-control study

Abstract

BACKGROUND: Sudden infant death syndrome is used when a sleeping infant under one year of age, who has presumably been quite well, is found unexpectedly dead and remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene, and review of the clinical history. Safe sleep campaigns and the progress in understanding risk factors have significantly contributed to the decrease in its incidence. Nevertheless, the rate of reduction has now slowed and still remains a leading cause of post neonatal mortality in many developed countries. Strategic action is needed to tackle this problem. Recently, a decreased neonatal cholinesterase activity (BChE) has been suggested to be an important risk to consider. OBJECTIVES: The main objective is to determine if the absence of BChE’s basic monomer in dried heel blood taken after 48-72 hours of birth in the neonatal screening program is associated with sudden infant death syndrome. And the secondary objective is to carry out a descriptive study with the epidemiological information of the cases of the studied period. STUDY DESIGN: This is a pilot, retrospective, case-control study carried out in Catalunya. Each case will be matched with 10 living controls according to sex and weeks of gestation. A population of 88 cases and 880 controls will be studied. The determination of the monomer will be done with tandem mass spectrometry. PARTICIPANTS: Cases: Infants who died from sudden infant death syndrome in the last five years. Extracted from forensic records of the “Institut de Patologia Forense de Catalunya”. Controls: Alive children born during the month before or after the date of birth of the cases. Obtained from the census of the “Laboratori Central de Cribratge de Catalunya”