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Repeat sudden unexpected and unexplained infant deaths: natural or unnatural?

R G Carpenter1, A Waite, R C Coombs

  • 1Medical Statistics Unit, Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK. bob.carpenter@lshtm.ac.uk

Lancet (London, England)
|January 11, 2005
PubMed

Insights

Repeat unexpected infant deaths are typically natural, not unnatural. This study found a ratio of 6.7 natural to unnatural deaths among infants in the Care of Next Infant programme.

Area of Science:

  • Pediatrics
  • Forensic Pathology
  • Public Health

Background:

  • Previous suggestions indicated a higher likelihood of unnatural causes for recurrent unexplained infant deaths.
  • The Care of Next Infant (CONI) programme supports families experiencing such tragedies.

Purpose of the Study:

  • To estimate the probability of a second infant death being natural versus unnatural.
  • To investigate the causes of death in infants within families with a history of sudden infant death syndrome (SIDS).

Main Methods:

  • A cohort of 6373 infants enrolled in the CONI programme by December 1999 was studied.
  • Detailed investigations included family interviews, autopsy reviews, and case discussions for CONI deaths.
  • Data from England, Wales, and Northern Ireland were analyzed.

Main Results:

  • 57 (8.9 per 1000) CONI infants died; 48 were unexpected deaths.
  • Of 46 first CONI deaths, 40 were natural and six were probable homicides.
  • 18 families experienced two sudden infant death syndrome deaths; two had probable double homicides.

Conclusions:

  • Repeat unexpected infant deaths are predominantly natural.
  • The study provides statistical evidence to counter the assumption of unnatural causes in recurrent infant deaths.
Abstract

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