Queen Square Centre for Neuromuscular Diseases, Institute of Neurology, University College London, London, UK.
Centre for Child and Adolescent Health, University of Bristol School of Social and Community Medicine, Bristol, Bristol, UK.
Arch Dis Child. 2019 Oct;104(10):989-993. doi: 10.1136/archdischild-2018-316542. Epub 2019 Apr 20.
The sudden and unexpected death of an infant or child is devastating. An inability to explain why an infant or child died is difficult to accept for both families and professionals. No reliable national dataset exists to estimate precisely how many infants and children die unexpectedly each year in England. This lack of accurate epidemiological data belies the scale of this public health problem. Detailed controlled observational studies of infant deaths identifying risk factors and providing evidence-based advice for parents has seen a dramatic reduction in incidence over the last 30 years by almost 80% but greater knowledge is needed if future deaths of infants and older children are to be prevented and families optimally supported. We propose that a national registry of sudden unexpected deaths in infancy and childhood would accurately determine incidence, identify unknown risk factors and highlight good care practices, ensuring these can be standardised nationally. For such a project to be successful, however, parents must be at the heart of it. We held a consultation day between families, professionals and supporting charities (The Lullaby Trust, Child Bereavement UK, SUDC UK and CRY) to seek opinion on the desire for a registry and how best to ensure families are engaged. Here, we summarise our rationale for a registry and the feedback we received from attendees regarding their views of the proposal and the practical aspects of administering it.
婴儿或儿童的突然和意外死亡是毁灭性的。对于家庭和专业人士来说,无法解释婴儿或儿童的死因是难以接受的。英国没有可靠的国家数据集来准确估计每年有多少婴儿和儿童意外死亡。这种缺乏准确的流行病学数据掩盖了这一公共卫生问题的规模。对婴儿死亡进行详细的对照观察研究,确定风险因素,并为父母提供基于证据的建议,在过去 30 年中,发病率已经大幅下降了近 80%,但如果要预防未来婴儿和大龄儿童的死亡并为家庭提供最佳支持,还需要更多的知识。我们提议建立一个婴儿和儿童意外猝死的国家登记处,以准确确定发病率,确定未知的风险因素,并突出良好的护理实践,确保这些实践在全国范围内得到标准化。然而,要使这样的项目取得成功,父母必须成为项目的核心。我们举行了一次由家庭、专业人士和支持慈善机构(婴儿安睡基金会、儿童丧亲英国、儿童猝死英国和新生儿猝死症研究基金会)参加的咨询日,就建立登记处的意愿以及如何最好地确保家庭参与进行意见征询。在这里,我们总结了建立登记处的基本原理,以及与会者对该提案的看法以及管理该提案的实际方面的反馈。