National Paediatric Mortality Register, Children's University Hospital, Temple St, Dublin 1, Ireland.
Arch Dis Child. 2012 Aug;97(8):692-7. doi: 10.1136/archdischild-2011-301393. Epub 2012 Jun 9.
To examine the incidence of sudden unexplained death in children 1-4 years old (SUDC) in Ireland and to compare the epidemiological profile of SUDC with that of SIDS.
All cases of sudden unexplained death in children <5 years in Ireland between 1994 and 2008 were reviewed. Epidemiological information obtained from parental questionnaires and post-mortem reports was examined, and data on cases ≥52 weeks compared with cases <52 weeks.
SUDC accounted for 5% (n=44) of deaths in children aged 1-4 years during 1994-2008. During this period, the SIDS rate dropped from 0.71 to 0.34 per 1000 live births, while the SUDC rate increased from 0.08 to 0.18 deaths per 10 000 population aged 1-4 years. The median age of SUDC cases was 71.5 weeks, and the male/female ratio was 1.3:1. All died during a sleep period, 71% between 10pm and 8am, and more than two-thirds were found prone. Fewest cases occurred during July-September (11%), and a greater proportion occurred at weekends (55%). 52% (17/33) had symptoms (any) in the 48 h before death, and 35% (11/31) visited their general practitioner because of illness in the week preceding death. SUDC differed from SIDS in prevalence of maternal smoking (38% vs 72%, p<0.001), bed-sharing (17% vs 49%, p<0.001), and whether found prone (72% vs 23%, p<0.001).
While SUDC shares some characteristics with SIDS, there are also some important differences. Further data collection will help determine whether SIDS and SUDC represent the same pathophysiological entity. Standardisation of protocols for investigating sudden deaths is urgently required for accurate diagnosis of cases.
研究爱尔兰 1-4 岁儿童不明原因猝死（SUDC）的发生率，并比较 SUDC 与 SIDS 的流行病学特征。
对 1994 年至 2008 年期间爱尔兰所有 5 岁以下儿童不明原因死亡的病例进行了回顾性研究。通过父母问卷和尸检报告获取了流行病学信息，并对 52 周以上的病例与 52 周以下的病例进行了比较。
SUDC 占 1994-2008 年间 1-4 岁儿童死亡的 5%（n=44）。在此期间，SIDS 的发病率从每 1000 例活产儿 0.71 例降至 0.34 例，而 SUDC 的发病率从每 10000 名 1-4 岁儿童中 0.08 例增至 0.18 例。SUDC 病例的中位年龄为 71.5 周，男女比例为 1.3:1。所有病例均在睡眠期间死亡，71%发生在晚上 10 点至早上 8 点之间，超过三分之二的病例呈俯卧位。SUDC 病例最少发生在 7-9 月（11%），周末（55%）发生的病例较多。在死亡前 48 小时内，52%（17/33）有症状（任何），在死亡前一周因疾病就诊的占 35%（11/31）。SUDC 与 SIDS 在母亲吸烟（38%比 72%，p<0.001）、同床睡（17%比 49%，p<0.001）和俯卧位（72%比 23%，p<0.001）方面存在差异。
虽然 SUDC 与 SIDS 有一些共同特征，但也存在一些重要差异。进一步的数据收集将有助于确定 SIDS 和 SUDC 是否代表相同的病理生理实体。迫切需要制定研究猝死的标准方案，以准确诊断病例。
