doi:10.1016/j.jflm.2006.11.005
Copyright © 2007 Elsevier Ltd and FFLM All rights reserved.
Original Communication
Hemoglobin F in sudden infant death syndrome: A San Diego SIDS/SUDC Research Project report
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Henry F. Krous MDa, b,
,
, Elisabeth A. Haas MPHa, Amy E. Chadwick BAa, Homeyra Masoumi MDa, Christina Stanley MDc and Gary W. Perry PhDd
aRady Children’s Hospital and Health Center, 3020 Children’s Way, MC5007, San Diego, CA 92123, United States
bUniversity of California, San Diego School of Medicine, La Jolla, CA, United States
cOffice of the Chief Medical Examiner, San Diego County, San Diego, CA, United States
dCenter for Complex Systems and Brain Sciences, Florida Atlantic University, Boca Raton, FL 33431, United States
Received 6 September 2006;
revised 21 November 2006;
accepted 21 November 2006.
Available online 26 March 2007.
Abstract
Whether levels of fetal hemoglobin (HbF), a possible marker of antecedent hypoxemia, are increased in sudden infant death syndrome (SIDS) compared to controls is unresolved. Our aims are to: (1) Compare percent fetal hemoglobin (%HbF) levels in SIDS and control cases, and (2) compare our findings with those reported in previous studies. Using Triton-acid-urea gel electrophoresis and quantitative densitometry, %HbF was determined in whole blood specimens obtained at autopsy from SIDS and control cases accessioned into the San Diego SIDS/SUDC Research Project database. The SIDS and control cases were not different with respect to mean age, gender, gestational age, method of delivery, birth weight, or mean autopsy interval; %HbF levels in SIDS and control cases were not significantly different. Given that our results were obtained using optimal methods in well-defined SIDS and control cases, we concur with others that %HbF is not elevated in SIDS.
Keywords: SIDS; Fetal hemoglobin; Sudden infant death; Hypoxia
Fig. 1. Relationship of percent fetal hemoglobin (%HbF) and post-conceptual age in SIDS and control cases. The R values for SIDS and control cases are 0.66 and 0.87, respectively. The R value for the pooled samples is 0.726, indicating no difference between the two groups after accounting for PCA.
Table 1.
Manner and cause of death for 107 cases of sudden infant death, 1993–2001
a Unexplained sudden infant death.
1
Table 2.
Comparison of SIDS and control cases
a Not significant.
b Pre-maturity defined as <37 weeks gestation.
c PMI = Post-mortem interval.
Table 3.
Relationship of SIDS risk factors and %HbF
a Includes Asian/Pacific Islander, Native American/Alaskan Native and multiracial infants.
b Not significant.
c Pre-maturity is defined as <37 weeks gestation.
Table 4.
Comparison of studies evaluating fetal hemoglobin in SIDS

CAE = citric agar electrophoresis; HPLC = High performance liquid chromatography; IEF = isoelectric focusing; IF = immunoflourescence microscopy; PGE = polyacrylamide-gel electrophoresis; RID = radial immunodiffusion; TGE = triton-acid-urea gel electrophoresis and quantitative densitometry.
a AD = alkali denaturation.
b PCA = Post-conceptual age.

Corresponding author. Address: Rady Children’s Hospital and Health Center, 3020 Children’s Way, MC5007, San Diego, CA 92123, United States. Tel.: +1 858 966 5944; fax: +1 858 974 8087.