Each year, in France, around 300 babies under the age of one die unexpectedly. This is equivalent to ten kindergarten classes. In a third of cases, these children slept on their stomachs (ventral decubitus), a sleeping position formally prohibited by specialists since the 1990s, when English researchers Pete Blair and Peter Fleming identified it as a risk factor. In half of the cases, these deaths are called “sudden death” because there is no apparent cause.
It is to finally unravel this mystery that the National Observatory of Unexpected Infant Deaths (Omin) was born in 2015, at the University Hospital of Nantes, in connection with the forty or so referral centers that mesh the French territory and associations of affected families.
Data co-ordination
The Omin brings together a coordinator, a nurse, a data manager (data manager), a biostatistician, a regulatory referent and a team of doctors. It collects data from all deaths recorded in these centers (1,257 children since 2015) and, since 2020, collects biological samples (blood, urine, stool, hair, etc.).
The Observatory has already produced a map of the deaths recorded, in conjunction with Public Health France, showing that certain regions are more affected than others (Île-de-France, in particular, with 263 deaths since 2015). He also notes that the majority of these deaths occur before the age of 4 months and affect boys more than girls.
Study of genetic markers
Apart from the prone position, smoking, bed clutter or prematurity are already identified as risk factors. But other elements are under consideration. “Precariousness and health inequalities play a significant roleraises Christèle Gras-Le Guen, pediatrician at the Nantes University Hospital and scientific coordinator of Omin. One of our teams, for example, will publish an article showing that children who are vaccinated and well monitored medically are less at risk than others.», she announces.
The Observatory also relies heavily on new research techniques called “omics”, working at the level of genes, molecules and enzymes, to identify certain biomarkers likely to increase the risk of death. Australian researchers have just discovered an enzyme responsible for the fragility of the respiratory system of certain babies. «The perspective is to target the children most at risksays the pediatrician. These should absolutely not sleep on their stomachs or with a blanket on their heads. »