Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK.
Children and Family Services, Birmingham Community Healthcare NHS Trust, Aston, UK.
Arch Dis Child. 2019 Jan;104(1):30-36. doi: 10.1136/archdischild-2018-315156. Epub 2018 May 25.
To develop a detailed understanding of the circumstances of sudden unexpected death in infancy (SUDI) cases subject to serious case review (SCR).
This was a thematic analysis of SCRs relating to cases of SUDI in England. SCRs were obtained for SUDI cases dying between 1 April 2011 and 31 March 2014. These were cases (aged 0-2 years) that presented as a SUDI and for which no clear medical or forensic cause of death was found.
SCRs were held for 30 SUDI cases, published reports were available for 27/30. The median (range) age at death was 2 (0-19) months. Background risk factors in families included: alcohol or drug dependency in 18/27, parental mental health problems in 14/27, domestic abuse in 9/27 and parental criminal records in 13/27. Nineteen infants had received support from social care, 10/19 were subject to child protection plans. Neglect was a feature in 15/27 cases. Parents did not engage with professionals in 18/27 cases, involving social care in 14/18, health care in 13/18 and drug and substance misuse services in 5/18. Eighteen of 27 deaths occurred in highly hazardous sleep environments, 16/18 involved cosleeping and 13/16 cosleeping deaths occurred with parents who were intoxicated with alcohol or impaired by drugs.
Most SUDI cases occurred in hazardous sleep environments and are potentially preventable. They occurred in families well known to services with concerns about neglect, substance misuse and poor engagement. More consideration is needed on how best to support such vulnerable families.
深入了解接受严重案例审查（SCR）的婴儿猝死综合征（SUDI）案例的情况。
这是对英格兰 SUDI 案例 SCR 的主题分析。SCR 是为 2011 年 4 月 1 日至 2014 年 3 月 31 日期间死亡的 SUDI 案例获得的。这些案例（年龄 0-2 岁）表现为 SUDI，且未发现明确的医疗或法医死因。
对 30 例 SUDI 案例进行了 SCR，其中 27/30 有已发表的报告。死亡时的中位（范围）年龄为 2（0-19）个月。家庭中的背景风险因素包括：18/27 例存在酒精或药物依赖，14/27 例存在父母心理健康问题，9/27 例存在家庭虐待，13/27 例存在父母犯罪记录。19 例婴儿得到了社会关怀的支持，10/19 例受到儿童保护计划的保护。15/27 例存在忽视。18/27 例病例中父母未与专业人员接触，涉及社会关怀 14/18 例，医疗保健 13/18 例，药物和物质滥用服务 5/18 例。27 例死亡中有 18 例发生在高度危险的睡眠环境中，16/18 例涉及同睡，13/16 例同睡死亡发生在父母醉酒或药物滥用的情况下。
大多数 SUDI 病例发生在危险的睡眠环境中，是可以预防的。这些病例发生在服务机构熟知的家庭中，这些家庭存在忽视、药物滥用和不良参与的问题。需要更多考虑如何最好地支持这些弱势家庭。
