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Regional Infant and Child Mortality Review Committee: 2009 final report
1Sanford School of Medicine, The University of South Dakota, USA.
Insights
The Regional Infant and Child Mortality Review Committee reviewed 23 child deaths in 2009. While Sudden Infant Death Syndrome (SIDS) deaths declined, undetermined infant deaths, often linked to asphyxia, are increasing.
Area of Science:
- Public Health
- Pediatric Mortality Review
- Infant Death Investigation
Background:
- The Regional Infant and Child Mortality Review Committee (RICMRC) reviews infant and child deaths to inform actions protecting young lives.
- Established in 1997, RICMRC aims to transform data from reviewed deaths into actionable strategies.
- The 2009 report covers 23 deaths across ten counties, including criteria for hospital discharge and regional cause attribution.
Purpose of the Study:
- To present the findings of the 2009 annual report from the RICMRC.
- To analyze trends in infant and child mortality within the specified ten-county region.
- To examine the classification and potential causes of infant deaths, including Sudden Unexpected Infant Death (SUID) and Sudden Infant Death Syndrome (SIDS).
Main Methods:
- Review of 23 infant and child deaths meeting specific criteria in 2009.
- Analysis of death investigation protocols and classification trends over several years.
- Comparison of regional SIDS rates with national data.
Main Results:
- No deaths were categorized as Sudden Infant Death Syndrome (SIDS) in 2009.
- A stable decline in SIDS deaths was observed, with a slight increase in 2008.
- An increase in "undetermined" infant deaths, often associated with asphyxial risks, was noted, potentially reflecting a national trend.
Conclusions:
- The region's SIDS incidence appears close to the national average.
- A potential "diagnostic drift" may be occurring, with some SIDS cases now classified as SUID (Sudden Unexpected Infant Death).
- Increasing recognition of asphyxial risks in infant death scenes is a significant finding, mirroring national trends.
Abstract:
The 2009 annual report of the Regional Infant and Child Mortality Review Committee (RICMRC) is presented. Since 1997, RICMRC has sought to achieve its mission to "review infant and child deaths so that information can be transformed into action to protect young lives." For the year 2009, the Committee reviewed 23 deaths from Minnehaha, Turner, Lincoln, Moody, Lake, McCook, Union, Hanson, Miner and Brookings counties that met the following criteria: Children under age 18 dying subsequent to hospital discharge following delivery. Children who either died in these counties from causes sustained in them, or residents who died elsewhere from causes sustained in the 10-county region. The acronym SUID, (Sudden Unexpected Infant Death), is being increasingly used by investigators of infant deaths. SUID is an intentionally broad category used for any infant death where the cause of death is unapparent or multifactorial. Sudden Infant Death Syndrome (SIDS) is a subset of SUID. No deaths categorized as SIDS occurred in 2009. The committee has observed a stable decline in the number of deaths due to SIDS for the last several years with the exception of two SIDS deaths that occurred in 2008. The national SIDS rate of 0.55 per 1000 live births would suggest that our region should have one SIDS death per year. It would appear, on the average, that our region's SIDS incidence is close to that number. Many investigators believe that a "diagnostic drift" is occurring in the SIDS diagnosis. These investigators believe that some deaths certified as SIDS in earlier years may now be classified as "undetermined," or in the new terminology, SUID. Although the committee strives to be consistent year to year in its death investigation protocols, we have noticed that the number of deaths classified as "undetermined" has been increasing over the last few years (Figure 1). The majority of our "undetermined" manners of infant deaths appear to be related to concerns about possible asphyxial risks (e.g., overlaying, re-breathing and true suffocation). Our data may be mirroring a national trend among death investigators to increasingly recognize asphyxial risks in infant death scenes.
