Randall Brad, Thompson Paul, Wilson Ann
Department of Pathology, Sanford School of Medicine, University of South Dakota, 812 Covel Ave, Sioux Falls, SD, 57104, USA.
Department of Pediatrics and Internal Medicine, Sanford School of Medicine, University of South Dakota, 812 Covel Ave, Sioux Falls, SD, 57104, USA.
J Forensic Leg Med. 2019 Feb;62:52-55. doi: 10.1016/j.jflm.2019.01.003. Epub 2019 Jan 10.
Sudden Unexpected Infant Deaths (SUID) is defined as a combination of Sudden Infant Death Syndrome (SIDS), Unknown Cause of Death (UCD) and Accidental Suffocation and Strangulation in Bed (ASSB). Overall rates from 2000 to 2015 have been trending down. Racial differences in occurrence are seen.
Using the CDC Wonder Database, the total rates of SUID and its subsets were examined.
Non-Caucasian infant death rates for the total SUID group, and the SIDS component, are trending downward significantly faster than for Caucasians. UCD trends in rates show an apparent small, non-significant, decline for non-Caucasians, and are unchanged for Caucasians. ASSB rates are trending upward slightly more rapidly (not significantly) for non-Caucasians than Caucasians.
The trend showing ASSB trending upward more in non-Caucasians than Caucasians may suggest: 1) A racial difference that certifiers are more willing to certify SIDS than ASSB in Caucasians, and/or 2) Certifiers are biased towards certifying more ASSB than SIDS in non-Caucasians, and/or 3) Asphyxia risks may be increasing more in non-Caucasian SUIDs. Option #1 would require educational efforts to recognize the asphyxia risks in Caucasians. Option #2 would require documentation of racial bias in infant death certification followed by efforts to reduce the bias. Option #3 would require focused targeting of non-Caucasian populations to reduce asphyxia risks. Potentially all three scenarios could co-exist.
婴儿猝死（SUID）被定义为婴儿猝死综合征（SIDS）、死因不明（UCD）和床上意外窒息与勒死（ASSB）的综合情况。2000年至2015年的总体发生率呈下降趋势。在发生率上存在种族差异。
使用疾病控制与预防中心（CDC）的Wonder数据库，对SUID及其子类别进行了总体发生率的研究。
非白种人婴儿在SUID总群体以及SIDS类别中的死亡率下降趋势明显快于白种人。非白种人UCD发生率的趋势显示出明显的小幅下降（不显著），而白种人的发生率则无变化。非白种人ASSB的发生率上升趋势略快于白种人（不显著）。
非白种人ASSB发生率上升趋势高于白种人的情况可能表明：1）在认证方面存在种族差异，认证人员对白种人中的SIDS比对ASSB更愿意认证，和/或2）认证人员在非白种人中比对SIDS更倾向于认证更多的ASSB，和/或3）非白种人SUID中的窒息风险可能增加得更多。选项1需要进行教育，以认识到白种人中的窒息风险。选项2需要记录婴儿死亡认证中的种族偏见，随后努力减少这种偏见。选项3需要针对非白种人群体，以降低窒息风险。这三种情况可能同时存在。
