Department of Emergency Medicine, National Taiwan University Hospital and Medical College, National Taiwan University, Taiwan; Graduate Institute of Clinical Medicine, National Taiwan University Hospital and Medical College, National Taiwan University, Taiwan.
Pediatrics, National Taiwan University Hospital and Medical College, National Taiwan University, Taiwan.
J Formos Med Assoc. 2020 Dec;119(12):1842-1853. doi: 10.1016/j.jfma.2020.02.012. Epub 2020 Mar 13.
To investigate the cumulative postnatal risk of pediatric sudden death (SD) for each neonate and the temporal/regional differences which are still unclear.
We established a birth cohort (2000-2014) from our national database and obtained reference data about the United States (US) from the national website.
Among 3,097,277 live births, we identified 1661 children with SD (56.8% male). The postnatal cumulative risk of SD was 0.35, 0.49, 0.56 and 0.59/1000 by age 0, 5, 11 and 14 years. Coexisting cardiac diagnosis was noted in 347 (20.9%) and non-cardiac diagnosis in 300 (18.1%) patients. Cumulative all-cause mortality was 5.3, 6.78, 7.63 and 8.06/1000 by age 0, 5, 11 and 14 years. Risks of SD and all-cause death decreased over birthyear. SD risk decreased particularly after the 2008 birthyear. Risks of SD and all-cause death were the highest in Eastern Taiwan, but SD/all-cause death ratio was high in Taipei metropolitan and Northern Taiwan. Cumulative risk of SD (0.54/1000 by age 14) and all-cause mortality (9.06/1000 by age 14) in the US decreased over time. African-Americans were at the highest risks of SD and all-cause mortality. However, American-Indians/Alaska-natives exhibited the highest SD/all-cause death ratio.
This study provides the cumulative risk of SD (1 in 1694 newborns) by age 14 years. The time trend underlines the effect of medical advance and education on SD prevention. Distinct regional/ethnic differences in risks of SD and all-cause death in Taiwan and the US indicate the necessity of different strategies to diminish the disparity.
为了研究每个新生儿发生儿科猝死（SD）的累积产后风险，以及仍不清楚的时间/区域差异。
我们从国家数据库中建立了一个出生队列（2000-2014 年），并从国家网站获得了有关美国（US）的参考数据。
在 3097277 例活产中，我们确定了 1661 例 SD 儿童（56.8%为男性）。SD 的产后累积风险分别为 0.35、0.49、0.56 和 0.59/1000 岁，5、11 和 14 岁。347 例（20.9%）存在并存心脏诊断，300 例（18.1%）存在非心脏诊断。0、5、11 和 14 岁时，全因死亡率的累积分别为 5.3、6.78、7.63 和 8.06/1000。SD 和全因死亡的风险随着出生年份的增加而降低。特别是自 2008 年以来，SD 风险有所下降。SD 和全因死亡的风险在台湾东部最高，但台北都会区和台湾北部的 SD/全因死亡比例较高。SD 的累积风险（14 岁时为 0.54/1000）和全因死亡率（14 岁时为 9.06/1000）在美国随着时间的推移而降低。非裔美国人患 SD 和全因死亡的风险最高。然而，美洲印第安人/阿拉斯加原住民的 SD/全因死亡率最高。
本研究提供了 14 岁时 SD（每 1694 名新生儿中就有 1 名）的累积风险。时间趋势强调了医疗进步和教育对 SD 预防的影响。台湾和美国在 SD 和全因死亡风险方面存在明显的区域/种族差异，表明需要采取不同的策略来缩小差距。
