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C-Section, Stillbirths, Miscarriages and SIDS

I am close to my due date with my first "sub sib" and will have to go C-Section. My question: is there any research or correlation between APGAR scores at birth and SIDS? My daughter while living 13 1/2 months without any health problems had a terrible delivery. It ended up that I had CPD (she was to big and I was to small to deliver her safely). She came out blue and need oxygen. Her APGAR scores were 2 and 5. Is there a possibility that her tough delivery may had something to do with SIDS? Is there any evidence that lack of oxygen during a infants existence may result in unnoticed damage that eventually results in SIDS?

My daughter was born by emergency C-section because of fetal distress. However, her APGAR scores were 8 and 9. I don't know of any research, but have also wondered about possible connections between a problem delivery and SIDS, or even C-sections in general and SIDS. Are babies born vaginally any less likely to die from SIDS?

Does anyone know of any research relating pH levels at birth (or any time) to SIDS? My daughter was born by emergency c-section because of fetal distress. Her pH had raised or lowered (can't remember) to a dangerous point. Could this have anything to do with metabolic problems that might be linked with SIDS? Would any of this be investigated in the autopsy?

She was fine after birth (8,9 apgars) and never had problems with her check-ups at the doctor. From the little I've seen about metabolic disorders, it seems like they would not be evident without a special test.

There is no evidence that C-section is associated with a higher risk of SIDS than vaginal birth.

Currently, stillbirths or miscarriages are not viewed as being the same as SIDS. However, I don't think that question is fully answered.

I do not believe there are any studies which show an increased SIDS risk with Cesarean birth, low APGARs, etc. The fairly large number of studies looking for "markers of chronic hypoxia" (low oxygen) generally are looking for evidence of prolonged low oxygen. These may, theoretically, occur before birth (in utero) and/or after birth.

I hope this helps. Thank you.

Tom Keens
Children's Hospital Los Angeles

There is no direct relationship between APGAR scores and risk for SIDS. There is 1 indirect link in the sense that very preterm infants tend to have lower APGAR scores and also (but unrelated) have higher SIDS rates than full term infants.

There is no relation between pH (low value=high blood acid level) at birth, and the later risk for SIDS. The fact that your daughter looked so good at delivery and on her check-ups confirms that the fetal distress just before delivery did not cause any later metabolic problem. Any metabolic problem that could have been related to SIDS (highly unlikely) should have some findings at autopsy.

Carl E. Hunt, M.D.
Toledo/Washington D.C.

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