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89 of 119 parents of infants with apnea home monitoring answered to a standard questionnaire concerning different aspects of home monitoring. In almost all cases the home monitoring was finished at the begin of the study, lasting from six months to 12 months. The indications for an apnea monitor were: apparent life threatening event (n = 8), SIDS-sibling (n = 24), sleep apnea syndrome (n = 40) and parents pressing request (n = 17). 90% of parents felt to have got enough information about the function of the apnea monitor (mostly Graseby MR-10 monitor) and what they have to do when there is an apnea alarm. 6% of parents changed the monitor because of technical problems. Most of the alarms were registrated by almost all parents between 24 h and 6 h. 35% of parents stimulated their infants in case of an apnea alarm gently to vigorously, one infant had a mouth to mouth resuscitation. Questions concerning the psychological and social impact of home monitoring on parents demonstrated that there was some stress like anxiety, sleep disturbances mainly in the mothers. We conclude from parents experience with apnea home monitoring the need for an adequate medical, technical and psychological support.

In a prospective study (1988-1990) the SIDS risk questionnaire SRFB was applied to 6000 infants born in the Department of Obstetrics, University Hospital Graz. In all infants at an increased statistical risk for SIDS a standardized intervention including pediatric and polysomnographic investigations was performed. As a result the SIDS incidence decreased from an average of 1.92 per thousand lifeborns (1984-1988) to 0.83 per thousand lifeborns (1989-1990) in our test group, which means a striking reduction of the SIDS incidence by 57%. In addition to this effect, the intensified information of parents and physicians about possible signs of an increased risk for SIDS lead to a general reduction of SIDS in Styria.

Based on the results from semistructured interviews with parents of fifty SIDS victims and of fifty matched controls we developed a SIDS risk questionnaire, the so-called SRFB Graz. In a retrospective study this questionnaire was applied to 65 SIDS victims and 195 comparable controls. By statistical analysis a cut point was computed, which discriminates SIDS cases from controls with a sensitivity of 86% and a specificity of 95%.

Because of the growing demand to evaluate cardiorespiratory dysfunctions the short-time oxycardiorespirography becomes a more and more important and powerful tool in the daily clinical routine. Therefore, from about one hour lasting records we studied the distribution of MA-values (mean apnea duration), duration of the longest apnea, percentage of periodic breathing time, lowest heart rate values, lowest transcutaneous PO2 values and highest transcutaneous PCO2 values in an obstetrical optimal low-risk group of 90 infants and a obstetrical non-optimal group of 152 infants between four and ten weeks of age. Percentiles of each variable were calculated, and we suggest the 90th percentiles as new threshold values to judge these short-time recordings. In comparison to relevant data from the literature we could demonstrate that deviating threshold values have to be applied to short-time recordings in comparison to long-time recordings. In addition, the respiratory behaviour of the optimal group is compared to that of the non-optimal group of the same age. Interestingly enough, no difference in the respiratory behaviour between these groups could be demonstrated.

We correlated the incidence of the sudden infant death syndrome (SIDS) and the degree of air pollution in each district of Graz over a time period of five years. The degree of air pollution was derived from a mapping of epiphytical lichen vegetation by Grill et al. (1988). We found an increased incidence of SIDS in districts with poor air quality. Although this result is not statistically significant a possible increase in SIDS risk because of air pollution cannot be excluded. Some pathophysiological explanations are discussed.

The question was posed, whether a relationship could be established between prenatal and perinatal events and subsequent sudden infant death. The birth records of eighty mothers, whose infants died of sudden infant death syndrome (SIDS) between 1982 and 1987, were reviewed for obstetric complications. The records immediately following the respective SIDS cases served as controls. A family history of SIDS was found significantly more often in the SIDS group than in the control group (p less than 0.001). Oxytocin was administered significantly more often in the SIDS group than in the control group: 54/80 (= 68%) and 20/80 (= 25%, p less than 0.001), respectively. Smoking, hypotension requiring treatment and the administration of tocolytic agents were found significantly more frequently in the SIDS group than in the control group (p less than 0.01, p less than 0.001, and p less than 0.05). Transient fetal hypoxia, as a result of reduced flow in the uterine artery, seems possibly to be connected to the vasoactive agent Oxytocin when occurring in the three above named groups. Whether these situations are connected to a later development of SIDS, has not, to date, been confirmed.

The parents of 80 victims of SIDS (Sudden Infant Death Syndrome) participated in this retrospective study. The semistructured interview included questions concerning events preceding infants' death and the situation at the discovery of the death. Fifty-eight of the 80 SIDS victims were male, twenty-two were female. Fourty-four of the babies underwent a postmortem examination. There was a high incidence of death during the winter months and concerning the hour of the day in the morning hours. Most families (91%) had no socioeconomic difficulties--in contrast to reports of other authors. In 34% of the SIDS cases the parents reported about stress or irregularities of the daily family life cycle (journey, mayor family events, quarrels) immediately before the death of the baby. About 20% of the victims were not in the usual surrounding at the time of death. In about 30% of the SIDS victims an infection was observed. Since between the 2nd and 4th month of life a major neuronal reorganization in the central nervous system is assumed (Prechtl, 1984), stress during this period may be particularly effective and dangerous for the baby. This would explain the high incidence of SIDS during this vulnerable phase (60%) in which the baby, apparently, is unable to react properly.