Abstract
OBJECTIVES—To compare the clinical characteristics associated with sudden infant death syndrome (SIDS) and explained sudden unexpected deaths in infancy (SUDI). DESIGN—Three year population based, case control study with parental interviews for each death and four age matched controls. SETTING—Five regions in England (population, > 17 million; live births, > 470 000). SUBJECTS—SIDS: 325 infants; explained SUDI: 72 infants; controls: 1588infants. RESULTS—In the univariate analysis, all the clinical features and health markers at birth, after discharge from hospital, during life, and shortly before death, significant among the infants with SIDS were in the same direction among the infants who died of explained SUDI. In the multivariate analysis, at least one apparent life threatening event had been experienced by more of the infants who died than in controls (SIDS: 12% v 3% controls; odds ratio (OR) = 2.55; 95% confidence interval (CI), 1.02 to 6.41; explained SUDI: 15% v 4% controls; OR = 16.81; 95% CI, 2.52 to 112.30). Using a retrospective illness scoring system based on "Baby Check", both index groups showed significant markers of illness in the last 24 hours (SIDS: 22% v 8% controls; OR = 4.17; 95% CI, 1.88to 9.24; explained SUDI: 49% v 8% controls; OR = 31.20; 95% CI, 6.93 to 140.5). CONCLUSIONS—The clinical characteristics of SIDS and explained SUDI are similar. Baby Check might help identify seriously ill babies at risk of sudden death, particularly in high risk infants.
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- Bartholomew S., MacArthur B. A. Comparison of infants dying from the sudden infant death syndrome with matched live controls. Soc Sci Med. 1988;27(4):393–397. doi: 10.1016/0277-9536(88)90274-2. [DOI] [PubMed] [Google Scholar]
- Blair P. S., Fleming P. J., Bensley D., Smith I., Bacon C., Taylor E., Berry J., Golding J., Tripp J. Smoking and the sudden infant death syndrome: results from 1993-5 case-control study for confidential inquiry into stillbirths and deaths in infancy. Confidential Enquiry into Stillbirths and Deaths Regional Coordinators and Researchers. BMJ. 1996 Jul 27;313(7051):195–198. doi: 10.1136/bmj.313.7051.195. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Brooke H., Gibson A., Tappin D., Brown H. Case-control study of sudden infant death syndrome in Scotland, 1992-5. BMJ. 1997 May 24;314(7093):1516–1520. doi: 10.1136/bmj.314.7093.1516. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cameron M. H., Williams A. L. Development and testing of scoring systems for predicting infants with high-risk of sudden infant death syndrome in Melbourne. Aust Paediatr J. 1986;22 (Suppl 1):37–45. [PubMed] [Google Scholar]
- Carpenter R. G., Gardner A., Pursall E., McWeeny P. M., Emery J. L. Identification of some infants at immediate risk of dying unexpectedly and justifying intensive study. Lancet. 1979 Aug 18;2(8138):343–346. doi: 10.1016/s0140-6736(79)90355-6. [DOI] [PubMed] [Google Scholar]
- Cole T. J., Gilbert R. E., Fleming P. J., Morley C. J., Rudd P. T., Berry P. J. Baby Check and the Avon infant mortality study. Arch Dis Child. 1991 Sep;66(9):1077–1078. doi: 10.1136/adc.66.9.1077. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Fedrick J. Sudden unexpected death in the Oxford Record Linkage Area. Details of pregnancy, delivery, and abnormality in the infant. Br J Prev Soc Med. 1974 Aug;28(3):164–171. doi: 10.1136/jech.28.3.164. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Fleming P. J., Blair P. S., Pollard K., Platt M. W., Leach C., Smith I., Berry P. J., Golding J. Pacifier use and sudden infant death syndrome: results from the CESDI/SUDI case control study. CESDI SUDI Research Team. Arch Dis Child. 1999 Aug;81(2):112–116. doi: 10.1136/adc.81.2.112. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ford R. P., Mitchell E. A., Stewart A. W., Scragg R., Taylor B. J. SIDS, illness, and acute medical care. New Zealand Cot Death Study Group. Arch Dis Child. 1997 Jul;77(1):54–55. doi: 10.1136/adc.77.1.54. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gilbert R. E., Fleming P. J., Azaz Y., Rudd P. T. Signs of illness preceding sudden unexpected death in infants. BMJ. 1990 May 12;300(6734):1237–1239. doi: 10.1136/bmj.300.6734.1237. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gilbert R., Rudd P., Berry P. J., Fleming P. J., Hall E., White D. G., Oreffo V. O., James P., Evans J. A. Combined effect of infection and heavy wrapping on the risk of sudden unexpected infant death. Arch Dis Child. 1992 Feb;67(2):171–177. doi: 10.1136/adc.67.2.171. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hoffman H. J., Hillman L. S. Epidemiology of the sudden infant death syndrome: maternal, neonatal, and postneonatal risk factors. Clin Perinatol. 1992 Dec;19(4):717–737. [PubMed] [Google Scholar]
- Jewell D. Helping parents identify severe illnesses in their children. BMJ. 1999 Jun 26;318(7200):1711–1712. doi: 10.1136/bmj.318.7200.1711. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kahn A., Blum D., Hennart P., Sellens C., Samson-Dollfus D., Tayot J., Gilly R., Dutruge J., Flores R., Sternberg B. A critical comparison of the history of sudden-death infants and infants hospitalised for near-miss for SIDS. Eur J Pediatr. 1984 Dec;143(2):103–107. doi: 10.1007/BF00445795. [DOI] [PubMed] [Google Scholar]
- McGlashan N. D. Sudden infant deaths in Tasmania, 1980-1986: a seven year prospective study. Soc Sci Med. 1989;29(8):1015–1026. doi: 10.1016/0277-9536(89)90059-2. [DOI] [PubMed] [Google Scholar]
- Mitchell E. A., Ford R. P., Stewart A. W., Taylor B. J., Becroft D. M., Thompson J. M., Scragg R., Hassall I. B., Barry D. M., Allen E. M. Smoking and the sudden infant death syndrome. Pediatrics. 1993 May;91(5):893–896. [PubMed] [Google Scholar]
- Moore A. Preventable childhood deaths in Wolverhampton. Br Med J (Clin Res Ed) 1986 Sep 13;293(6548):656–658. doi: 10.1136/bmj.293.6548.656. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Morley C. J., Thornton A. J., Cole T. J., Hewson P. H., Fowler M. A. Baby Check: a scoring system to grade the severity of acute systemic illness in babies under 6 months old. Arch Dis Child. 1991 Jan;66(1):100–105. doi: 10.1136/adc.66.1.100. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Newcastle survey of deaths in early childhood 1974/76, with special reference to sudden unexpected deaths. Working party for early childhood deaths in Newcastle. Arch Dis Child. 1977 Nov;52(11):828–835. doi: 10.1136/adc.52.11.828. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rintahaka P. J., Hirvonen J. The epidemiology of sudden infant death syndrome in Finland in 1969-1980. Forensic Sci Int. 1986 Feb-Mar;30(2-3):219–233. doi: 10.1016/0379-0738(86)90017-4. [DOI] [PubMed] [Google Scholar]
- Taylor E. M., Emery J. L. Family and community factors associated with infant deaths that might be preventable. Br Med J (Clin Res Ed) 1983 Sep 24;287(6396):871–874. doi: 10.1136/bmj.287.6396.871. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Thomson H., Ross S., Wilson P., McConnachie A., Watson R. Randomised controlled trial of effect of Baby Check on use of health services in first 6 months of life. BMJ. 1999 Jun 26;318(7200):1740–1744. doi: 10.1136/bmj.318.7200.1740. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Thornton A. J., Morley C. J., Green S. J., Cole T. J., Walker K. A., Bonnett J. M. Field trials of the Baby Check score card: mothers scoring their babies at home. Arch Dis Child. 1991 Jan;66(1):106–110. doi: 10.1136/adc.66.1.106. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Whybrew K., Murray M., Morley C. Diagnosing fever by touch: observational study. BMJ. 1998 Aug 1;317(7154):321–321. doi: 10.1136/bmj.317.7154.321. [DOI] [PMC free article] [PubMed] [Google Scholar]