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5MinuteConsult Journal Club

A Potential Blood Test for SIDS


Lancet 2022; eBioMedicine 2022;80: 104041

Study Summary

An infant’s failure to be aroused and wake when appropriate is considered a key risk for SIDS. Researchers in Australia identified a correlation between a reduced serum substance, butyrylcholinesterase (BChE) and an increased occurrence of SIDS, but not other forms of infant death.

Babies who died of SIDS had lower levels of the BChE enzyme in the first few days after birth. BChE plays a major role in the brain's arousal pathway, and low levels would reduce a sleeping infant's ability to wake up or respond to its environment.

This is a case control study where BChE activity and total protein were measured within 3 days of birth. The researchers found lower BChE specific activity (BChEsa) was associated with SIDS whereas in controls and those with a “Non-SIDS death” there was no evidence of an association.


Primary prevention of SIDS continues to have all infants:

--sleep on their back,

--use a firm mattress,

--encourage the mother to breast feed,

--share the room, but not the bed with the infant,

--put no objects, including blankets or stuffed animals, in with the baby, and

--have no one smoke near the baby.

While the utility of BChE is a hope for the future, it is not a standard of care and will not be available clinically for some time.

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Sudden Infant Death Syndrome (SIDS), Pediatric

Contributed by Frank J. Domino, May 18, 2022