Infant suffocation in place of sleep: New Zealand national data 2002–2009

Hayman, Rebecca; McDonald, Gabrielle; Baker, Nick; Mitchell, Edwin A.; Dalziel, Stuart R

doi:10.1136/archdischild-2014-306961

Cited by 18 publications

(23 citation statements)

References 18 publications

(21 reference statements)

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“…The risks for infants of cosleeping with a parent influenced by alcohol or drugs are well recognised, the most recent case–control study of SUDI determined an OR of 10.34 for infants cosleeping with parents who had consumed more than 2 units of alcohol or used illicit drugs when compared with similarly high-risk socially deprived controls 14. A review of national child mortality in New Zealand found that one-quarter of SUDI occurred away from home with infants sleeping in makeshift beds15; this is similar to our results where unplanned changed in family circumstances and living arrangements immediately preceded deaths in one-third of cases. Although none of the deaths were classified as due to accidental asphyxia, the circumstances of death would suggest that asphyxia was highly probable in many cases.…”

Section: Discussionmentioning

confidence: 99%

Qualitative analysis of serious case reviews into unexpected infant deaths

Garstang

Sidebotham

2018

Arch Dis Child

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Section: Discussionmentioning

confidence: 99%

Qualitative analysis of serious case reviews into unexpected infant deaths

Garstang

Sidebotham

2018

Arch Dis Child

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“…This reflects standard UK practice as in 2014 only 6 infant deaths nationally were registered with ICD10 code W75 (accidental suffocation and strangulation in bed) [19].There is a wide variation internationally in the use of ICD10 code W75 for infant sleep related deaths, ranging from 1.1% in Germany to 31.7% in New Zealand with England and Wales at 3.8% [20]; some of this variation may be due to differences in CDR with countries such as New Zealand having a robust CDR process [21]. Additionally, in our study only around half of unexplained deaths were categorised as SIDS with the remainder, especially those with more risk factors, labelled as undetermined.…”

Section: Discussionmentioning

confidence: 99%

Unintentional asphyxia, SIDS, and medically explained deaths: a descriptive study of outcomes of child death review (CDR) investigations following sudden unexpected death in infancy

Garstang

Ellis

Griffiths

et al. 2016

Forensic Sci Med Pathol

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BackgroundA comprehensive Child Death Review (CDR) program was introduced in England and Wales in 2008 but as yet data have only been analysed at a local level, limiting the learning from deaths. The aim of this study is to describe the profile of causes and risk factors for Sudden Unexpected Death in Infancy (SUDI) as determined by the new CDR program. MethodsThis was a descriptive outcome study using data from Child Death Overview Panel (CDOP) Form C for SUDI cases dying during 2010-2 in the West Midlands region of England. The main outcome measures were: cause of death, risk factors and potential preventability of death, and determination of deaths probably due to unintentional asphyxia. ResultsData were obtained for 65/70 (93%) SUDI cases. 20/65 (31%) deaths were initially categorised as due to medical causes; 21/65 (32%) as SIDS, and 24/65 (37%) as undetermined. Reanalysis suggested that 2/21 SIDS and 7/24 undetermined deaths were probably due to unintentional asphyxia, with 6 of these involving co-sleeping and excessive parental alcohol consumption. Deaths classified as 'undetermined' had significantly higher total family and environmental risk factor scores (mean 2.6, 95% CI 2.0-3.3) compared to those classified as SIDS (mean 1.6, 95% CI 1.2-1.9), or medical causes for death (mean 1.1, 95% CI 0.8-1.3). 9/20 (47%) of medical deaths, 19/21 (90%) SIDS and 23/24 (96%) undetermined deaths were considered to be potentially preventable. There were inadequacies in medical provision identified in 5/20 (25%) of medically explained deaths. ConclusionsThe CDR program results in detailed information about risk factors for SUDI cases but failed to recognise deaths probably due to unintentional asphyxia. The misclassification of probable unintentional asphyxial deaths and SIDS as 'undetermined deaths' is likely to limit learning from these deaths and inhibit prevention strategies. Many SUDI occurred in families with mental illness, substance misuse and chaotic lifestyles and most in unsafe sleep-environments. This knowledge could be used to better target safe sleep advice for vulnerable families and prevent SUDI in the future. Key Words Key pointsThe CDR program provides valuable information on the profile of causes and risk factors for SUDI but is currently not recognising deaths from unintentional asphyxia and often not classifying unexplained infant deaths as SIDS.Most SUDI still occur in hazardous sleep environments despite public health campaigns.Poor parenting, particularly the combination of excess parental alcohol consumption and cosleeping, was a factor in many unexplained SUDI deaths.Research is needed to help target safe-sleep information better at high risk families.Difficulties with health care service provision may have contributed to some medically explained deaths.

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“…Infants exposed to maternal cigarette smoking in the antenatal period have impaired arousal . A bed‐sharing environment provides a situation of multiple potential hazards for accidental asphyxia and hypoxia, especially for infants less physiologically capable of arousing and appropriately responding . Intervening in the substantial SUDI risk created by the interaction of bed‐sharing when there has been smoking in pregnancy provides the best opportunity to substantially impact SUDI rates …”

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confidence: 99%

Evaluation of a sudden unexpected death in infancy intervention programme aimed at improving parental awareness of risk factors and protective infant care practices

McIntosh

Trenholme

Stewart³

et al. 2017

J Paediatrics Child Health

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Bed-sharing and knowledge improvement were similar irrespective of group. It is likely that the impact of the intervention was reduced because the control group received better support than 'usual care' and all participants had a baby bed. New Zealand SUDI rates have declined since sleep space programmes have been available. Sleep space programmes should be prioritised for those with modifiable SUDI risk.

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Infant suffocation in place of sleep: New Zealand national data 2002–2009

Abstract: Accidental suffocation in bed was responsible for 48 preventable deaths. Prevention of these accidental deaths needs to focus on supporting changes in family behaviour with safety messages that are consistent, persistent and disseminated widely.

Cited by 18 publications

References 18 publications

Qualitative analysis of serious case reviews into unexpected infant deaths

Qualitative analysis of serious case reviews into unexpected infant deaths

Unintentional asphyxia, SIDS, and medically explained deaths: a descriptive study of outcomes of child death review (CDR) investigations following sudden unexpected death in infancy

Evaluation of a sudden unexpected death in infancy intervention programme aimed at improving parental awareness of risk factors and protective infant care practices

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