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Metabolites may help predict risk of sudden infant death syndrome

The findings may provide clues to develop better SIDS prevention and therapies. Monkey Business Images / Shutterstock

Sudden infant death syndrome (SIDS) is a leading cause of infant mortality nationwide. SIDS is defined as the sudden and unexplained death of an infant under 1 year of age that remains unexplained after a complete investigation. Although the causes of SIDS are poorly understood, several risk factors have been identified. These include smoking or alcohol use during pregnancy, the baby’s sleep position, and genetics.

Some studies had found evidence that molecules produced by the body’s chemical reactions, called metabolites, might also play a role. A research team led by Scott Oltman at the University of California, San Francisco, decided to take a closer look at the link between SIDS and metabolites in newborns. They took advantage of the fact that the state of California routinely screens all newborns for many serious disorders, including several conditions that affect metabolism.

From the more than 2 million infants born statewide between 2005 and 2011, the researchers identified 354 babies who later died of SIDS. The data from these infants were then matched to a control group of more than 1,400 similar infants who survived to at least 1 year of age. The results were reported on September 9, 2024, in JAMA Pediatrics.

The team identified eight metabolites that significantly differed between the SIDS and control groups. These included one hormone, two amino acids (the building blocks of proteins), and five acylcarnitines, which are necessary to break down fats to produce energy.

Using this and other data, such as the infants’ sex and mothers’ age, the scientists developed a model to assess the risk of SIDS. This model was then tested against a subset of infants that wasn’t used in forming the model.

The team found that infants with the highest risk profile in their model were more than 14 times as likely to die of SIDS than those with the lowest risk profile.

“This study suggests that metabolic factors may play a crucial role in SIDS,” Oltman says. “These patterns could help identify children at higher risk, potentially saving lives in the future.”

The model will have to be tested and refined in other populations. Although the people in this study were highly diverse, a large proportion self-identified as Hispanic (41%).

These results also point the way to further studies into why these metabolites might be altered in SIDS. A better understanding of what causes the different metabolic patterns could lead to the development of new therapeutic and prevention strategies.