Alessandri L M, Read A W, Dawes V P, Cooke C T, Margolius K A, Cadden G A
Institute for Child Health Research, West Perth, Western Australia.
Paediatr Perinat Epidemiol. 1995 Oct;9(4):406-19. doi: 10.1111/j.1365-3016.1995.tb00164.x.
Previous research showed that the sudden infant death syndrome (SIDS) rate for Aboriginal infants significantly increased during the 1980s in Western Australia (WA) and raised the possibility of a diagnostic transfer of Aboriginal infant deaths from other causes to SIDS over this period. Here, therefore we review the pathology of SIDS and other sudden and unexpected deaths in infancy (SUDI) for Aboriginal and non-Aboriginal infants in WA between 1980 and 1988. The aim was to investigate whether there had been differences in the diagnosis and/or classification of SIDS according to whether the infants were Aboriginal or non-Aboriginal. The study population comprised: (1) all Aboriginal cases of SIDS and other SUDI between 1980 and 1988, and (2) corresponding random samples of non-Aboriginal cases. A two-stage process was employed for the review. First, histology slides were reviewed for each case where the aboriginality of the infant was Aboriginal and the original cause of death were unknown to the pathologists. Second, all paper records (i.e. death scene investigations, laboratory tests and medical reports) except for the original cause of death information were reviewed by the pathologists. The results showed that there was excellent agreement between the final review diagnosis and the original diagnosis for both Aboriginal and non-Aboriginal SUDI. Thus, there was no evidence for a diagnostic shift among Aboriginal infant deaths and the review supported the observed increase in the SIDS rate for Aboriginal infants.
先前的研究表明，20世纪80年代西澳大利亚州（WA）原住民婴儿的婴儿猝死综合征（SIDS）发生率显著上升，这增加了在此期间原住民婴儿死亡原因从其他原因诊断为SIDS的可能性。因此，我们在此回顾1980年至1988年间西澳大利亚州原住民和非原住民婴儿SIDS及其他婴儿期突然意外死亡（SUDI）的病理学情况。目的是调查根据婴儿是原住民还是非原住民，SIDS的诊断和/或分类是否存在差异。研究人群包括：（1）1980年至1988年间所有原住民SIDS和其他SUDI病例，以及（2）相应的非原住民病例随机样本。回顾采用两阶段流程。首先，对婴儿为原住民且病理学家不知其原死亡原因的每个病例的组织学切片进行回顾。其次，病理学家对除原死亡原因信息外的所有纸质记录（即死亡现场调查、实验室检查和医学报告）进行回顾。结果表明，对于原住民和非原住民SUDI，最终回顾诊断与原诊断之间具有高度一致性。因此，没有证据表明原住民婴儿死亡存在诊断转变，且该回顾支持了观察到的原住民婴儿SIDS发生率上升的情况。
