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Major epidemiological changes in sudden infant death syndrome : a 20-year population-based study in the UK

By Peter S. Blair, Peter Sidebotham, Jeremy Berry, Margaret Evans and Peter J. Fleming

Abstract

Background\ud Results of case-control studies in the past 5 years suggest that the epidemiology of sudden infant death syndrome (SIDS) has changed since the 1991 UK Back to Sleep campaign. The campaign's advice that parents put babies on their back to sleep led to a fall in death rates. We used a longitudinal dataset to assess these potential changes.\ud Methods\ud Population-based data from home visits have been collected for 369 consecutive unexpected infant deaths (300 SIDS and 69 explained deaths) in Avon over 20 years (1984—2003). Data obtained between 1993 and 1996 from 1300 controls with a chosen “reference” sleep before interview have been used for comparison.\ud Findings\ud Over the past 20 years, the proportion of children who died from SIDS while co-sleeping with their parents, has risen from 12% to 50% (p<0·0001), but the actual number of SIDS deaths in the parental bed has halved (p=0·01). The proportion seems to have increased partly because the Back to Sleep campaign led to fewer deaths in infants sleeping alone—rather than because of a rise in deaths of infants who bed-shared, and partly because of an increase in the number of deaths in infants sleeping with their parents on a sofa. The proportion of deaths in families from deprived socioeconomic backgrounds has risen from 47% to 74% (p=0·003), the prevalence of maternal smoking during pregnancy from 57% to 86% (p=0·0004), and the proportion of pre-term infants from 12% to 34% (p=0·0001). Although many SIDS infants come from large families, first-born infants are now the largest group. The age of infants who bed-share is significantly smaller than that before the campaign, and fewer are breastfed.\ud Interpretation\ud Factors that contribute to SIDS have changed in their importance over the past 20 years. Although the reasons for the rise in deaths when a parent sleeps with their infant on a sofa are still unclear, we strongly recommend that parents avoid this sleeping environment. Most SIDS deaths now occur in deprived families. To better understand contributory factors and plan preventive measures we need control data from similarly deprived families, and particularly, infant sleep environments.\u

Topics: RJ
Publisher: The Lancet Publishing Group
Year: 2006
OAI identifier: oai:wrap.warwick.ac.uk:281

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  1. A multiagency protocol for responding to sudden unexpected death in infancy: descriptive study. doi
  2. and the CESDI SUDI research group. Babies sleeping with parents : case-control study of factors influencing the risk of sudden infant death syndrome. doi
  3. (1998). Back to sleep’ : the position in Oxfordshire and Northampton. Paediatr Perinat Epidemiol doi
  4. (2004). Bedsharing and sudden infant death syndrome (SIDS) in doi
  5. Can the fall in Avon's sudden infant death rate be explained by the observed sleeping position changes? doi
  6. (2003). Combined effect of infection and heavy wrapping on the risk of sudden infant death. doi
  7. (1996). Environment of infants during sleep and risk of the sudden infant death syndrome : results from 1993-5 case-control study for confidential inquiry into stillbirths and deaths in infancy. doi
  8. Investigating infant deaths. Ward-Platt MP. doi
  9. Investigating sudden unexpected deaths in infancy and childhood and caring for bereaved families : an integrated multiagency approach. doi
  10. Office of the Deputy Prime Minister &quot;2000 Index of Local Deprivation - Local Authority District Scores and Values on 12 Indicators&quot;.
  11. (1989). Statistics with confidence (second edition).
  12. (2003). Sudden Infant Death Syndrome and Social Deprivation . J. Paed Perinatal Epid. doi
  13. (2003). Sudden infant death syndrome: a critical review of approaches to research. Arch Dis Child. doi
  14. (2004). Sudden unexpected death in infancy. A multi-agency protocol for care and investigation. The Report of a working group convened by the Royal College of Pathologists and the Royal College of Paediatrics and Child Health. RCPath & RCPCH,
  15. Sudden unexpected deaths after discharge from the neonatal intensive care unit. doi
  16. Sudden Unexpected Deaths in Infancy: Similarities and differences in the epidemiology of SIDS and explained deaths.
  17. (2004). Terminology used by pathologists in reporting on sudden infant deaths. J Clin Pathol. doi
  18. (2002). The epidemic of SIDS in Norway 1967-93: changing effects of risk factors. Arch Dis Child 1997;77:23-27. 2 Fleming doi
  19. The interaction between bedding and sleeping position in sudden infant death syndrome: A population-based case-control study. doi
  20. (2004). The prevalence and characteristics associated with parent-infant bedsharing in England. Arch Dis Child.

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