Ethnic differences in infant health

Article Abstract:

In the United Kingdom (UK), as in the United States, consistent differences in infant health according to the ethnicity of their parents have emerged. The importance of categories used to define ethnicity is discussed, for example, the use of the term Asian does not distinguish among groups that may be included, such as Pakistani and Chinese. Similarly, if only the country of parental birth is addressed, other factors such as economic influences may be missed. Findings from studies of infant health and ethnicity are reviewed in this article. Particularly high rates of perinatal death (occurring just before, during, or just after birth) have been found for Pakistanis. High mortality continues throughout infancy in these children, but the factors contributing to this have not been particularly well studied. It was found, though, that up to one-third of Pakistani perinatal deaths were due to congenital malformations. In contrast, the incidence of death from congenital malformations was very low among mothers from West Africa and the Caribbean. Postneonatal mortality (after the newborn period) is higher in children born to British and Irish mothers than to those from Bangladesh, India, or East or West Africa. Sudden death from unknown cause was significant in postneonatal deaths where mothers were from the UK, Irish Republic, or Caribbean, while congenital anomalies were more important in those of Indian, Bangladeshi, African, and Pakistani women. Infants with low birth weights were common among mothers born in East Africa, in Hindu Asians, and in West Indians. Some studies suggest that low birth weight may not be entirely pathological among Asian babies or West Indian babies. Social class, poverty, quality of obstetric care, diet, maternal age, and consanguinity (marriage between relatives) may contribute to ethnic differences in infant health, but relatively little research has addressed these issues, and thus it is greatly needed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Children, Demographic aspects, Child health, Maternal and infant welfare, Infant welfare, Maternal welfare, Ethnic groups, Ethnicity

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Inherited metabolic diseases in the sudden infant death syndrome

Article Abstract:

Thirty years ago it was suggested that there may be a link between inherited metabolic diseases and sudden infant death syndrome (SIDS). It has been reported that inherited metabolic diseases may account for up to 10 percent of all cases of SIDS. More recently, studies have reported that a deficiency of an enzyme required for normal fatty acid metabolism (medium chain acyl CoA dehydrogenase, or MCAD) may be responsible for causing up to 3 percent of all cases of SIDS. In order to investigate this issue, all cases of SIDS occurring within a two-year period in Avon and north Somerset, England, were evaluated. During this time period, 109 babies died suddenly and unexpectedly. Samples of cerebrospinal fluid, urine, skin, and vitreous humor (a gel-like substance behind the lens of the eye) were collected from 95 of the infants and were examined for metabolic defects. Eighty-eight of the 95 infants were diagnosed as having SIDS. Seventy of the 88 cases of SIDS were tested for MCAD deficiency, but no cases of MCAD deficiency were found. Out of all the cases of SIDS studied, only one case of an inherited metabolic disease was identified. This case involved a deficiency of an enzyme called glucose-6-phosphatase that is required for breaking down glycogen (the storage form of glucose) and converting it into glucose. This disorder is called glycogen storage disease type 1C. The results of this study indicate that MCAD and other inherited metabolic diseases are not as common in SIDS as was previously thought. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Patient outcomes, Mortality, Causes of, Sudden infant death syndrome, Fatty acid metabolism, Metabolism, Inborn errors of, Inborn errors of metabolism

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