Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia;
DB Consulting Group, Inc, Silver Spring, Maryland.
Pediatrics. 2021 May;147(5). doi: 10.1542/peds.2020-035873.
Sudden unexpected infant death (SUID) represents a broad group of explained and unexplained infant deaths (<1 year old). Explaining why SUID occurs is critical to understanding etiology and prevention. Death certificate data cannot differentiate explained from unexplained SUID cases nor describe the surrounding circumstances. We report SUID rates by explained and unexplained categories and describe demographics and history of recent injury or illness using the Centers for Disease Control and Prevention SUID Case Registry.
The registry is a population-based surveillance system built on Child Death Review programs. Data are derived from multiple sources, including death certificates, scene investigations, and autopsy reports. Cases included SUIDs reported by states or jurisdictions participating in the registry during 2011-2017. Cases were classified into explained and unexplained categories by using the registry's classification system. Frequencies, percentages, and mortality rates per 100 000 live births were calculated.
Of the 4929 SUID cases, 82% were categorized as unexplained. Among all cases, 73% had complete case information. Most SUIDs (72%) occurred in an unsafe sleep environment. The SUID mortality rate was 97.3 per 100 000 live births. Among explained and possible suffocation deaths, ∼75% resulted from airway obstruction attributed to soft bedding.
Unsafe sleep factors were common in explained and unexplained SUID cases, but deaths could only be classified as explained suffocation for ∼20% of cases. Further analysis of unexplained deaths, including continued improvements to death scene investigation and documentation, may generate hypotheses for physiologic and genetic research, advance our understanding of gaps in SUID investigation, and enhance our understanding of infants at highest risk.
突发意外婴儿死亡（SUID）代表了一大组可解释和无法解释的婴儿死亡（<1 岁）。解释 SUID 发生的原因对于了解病因和预防至关重要。死亡证明数据无法区分可解释和无法解释的 SUID 病例，也无法描述周围环境。我们报告了按可解释和无法解释类别划分的 SUID 发病率，并使用疾病控制与预防中心 SUID 病例登记处描述人口统计学和近期受伤或疾病的病史。
该登记处是一个基于儿童死亡审查计划的基于人群的监测系统。数据来自多个来源，包括死亡证明、现场调查和尸检报告。病例包括 2011 年至 2017 年期间参与登记处的州或司法管辖区报告的 SUID。病例通过登记处的分类系统分为可解释和无法解释类别。计算了每 10 万活产儿的频率、百分比和死亡率。
在 4929 例 SUID 病例中，82%被归类为无法解释。在所有病例中，73%有完整的病例信息。大多数 SUID（72%）发生在不安全的睡眠环境中。SUID 的死亡率为每 10 万活产儿 97.3 例。在可解释和可能窒息死亡中，约 75%是由于气道阻塞导致软床造成的。
不安全的睡眠因素在可解释和无法解释的 SUID 病例中很常见，但只能将约 20%的病例归类为解释性窒息。对无法解释的死亡进行进一步分析，包括继续改进死亡现场调查和记录，可能会为生理和遗传研究提出假设，增进我们对 SUID 调查差距的理解，并提高我们对风险最高的婴儿的理解。
