US infant mortality trends attributable to accidental suffocation and strangulation in bed from 1984 through 2004:
Carrie K Shapiro-Mendoza1, Melissa Kimball, Kay M Tomashek
1Centers for Disease Control and Prevention, Maternal and Infant Health Branch, Division of Reproductive Health, Mail Stop K-23, 4770 Buford Hwy NE, Atlanta, GA 30341-3717, USA. ayn9@cdc.gov
Insights
Accidental suffocation and strangulation in bed caused a fourfold increase in infant mortality rates since 1984. Prevention efforts must focus on high-risk infants and safer sleep environments to reduce these potentially preventable deaths.
Area of Science:
- Pediatric Mortality
- Injury Prevention
- Public Health
Background:
- Accidental suffocation and strangulation in bed are leading causes of injury-related infant deaths.
- These deaths are a subgroup of sudden, unexpected infant deaths (SUID).
- Understanding trends and characteristics is crucial for prevention.
Purpose of the Study:
- To explore trends in accidental suffocation and strangulation in bed (ASSB) deaths.
- To examine the characteristics of infants affected by ASSB.
- To identify contributing factors to these deaths.
Main Methods:
- Descriptive study analyzing US infant mortality data (1984-2004).
- Calculated cause-specific mortality rates and proportionate mortality for ASSB and SUID.
- Examined reported contributing factors to ASSB deaths.
Main Results:
- Infant mortality rates from ASSB quadrupled from 2.8 to 12.5 per 100,000 live births (1984-2004).
- Rates increased significantly between 1992-2004, particularly 1996-2004 (14% annual increase).
- Black male infants under 4 months were disproportionately affected; deaths occurred in beds, cribs, and couches.
Conclusions:
- Infant mortality due to ASSB has quadrupled since 1984, with the cause of increase unknown.
- Targeted prevention efforts are needed for high-risk populations.
- Promoting safer sleep environments is essential for caregivers.
Objective:
Accidental suffocation and strangulation in bed, a subgroup of sudden, unexpected infant deaths, is a leading mechanism of injury-related infant deaths. We explored trends and characteristics of these potentially preventable deaths.
Methods:
In this descriptive study, we analyzed US infant mortality data from 1984 through 2004. To explore trends in accidental suffocation and strangulation in bed and other sudden, unexpected infant deaths, we calculated cause-specific infant mortality rates and estimated proportionate mortality. Sudden, unexpected infant death was defined as a combination of all deaths attributed to accidental suffocation and strangulation in bed, sudden infant death syndrome, and unknown causes. Finally, we examined factors that were reported as contributing to these accidental suffocation and strangulation in bed deaths.
Results:
Between 1984 and 2004, infant mortality rates attributed to accidental suffocation and strangulation in bed increased from 2.8 to 12.5 deaths per 100000 live births. These rates remained relatively stagnant between 1984 and 1992 and increased between 1992 and 2004; the most dramatic increase occurred between 1996 and 2004 (14% average annual increase). In contrast, total sudden, unexpected infant death rates remained stagnant between 1996 and 2004, whereas the proportion of deaths attributed to sudden infant death syndrome declined and to unknown cause increased. Black male infants <4 months of age were disproportionately affected by accidental suffocation and strangulation in bed. Beds, cribs, and couches were reported as places where deaths attributed to accidental suffocation and strangulation in bed occurred.
Conclusions:
Infant mortality rates attributable to accidental suffocation and strangulation in bed have quadrupled since 1984. The reason for this increase is unknown. Prevention efforts should target those at highest risk and focus on helping parents and caregivers provide safer sleep environments.
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