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Sudden unexpected death in infancy: aetiology, pathophysiology, epidemiology and prevention in 2015
Peter J Fleming1, Peter S Blair1, Anna Pease1
1Centre for Child and Adolescent Health, University of Bristol. St Michaels Hospital, Bristol, UK.
Insights
Unexpected infant deaths remain a concern despite
Area of Science:
- Pediatrics
- Public Health
- Forensic Pathology
Background:
- Unexpected infant deaths persist as a significant cause of mortality in the postneonatal period in Western countries.
- The 'Back to Sleep' campaigns reduced infant deaths, but challenges remain.
- Categorization changes and reluctance to use 'sudden infant death syndrome' (SIDS) complicate data analysis.
Purpose of the Study:
- To review the current understanding of unexpected infant deaths.
- To explore the epidemiology, aetiology, and pathophysiology of these deaths.
- To evaluate past interventions and discuss future prevention strategies.
Main Methods:
- Literature review of epidemiological and etiological data.
- Analysis of current hypotheses on the pathophysiology of infant deaths.
- Review of implemented and proposed interventions for mortality reduction.
Main Results:
- Unexpected infant deaths continue to be a major concern.
- Data accuracy is challenged by evolving classification systems.
- Effectiveness of interventions varies, necessitating new approaches.
Conclusions:
- Further research into the causes and prevention of unexpected infant deaths is crucial.
- Standardized classification and reporting are needed for accurate data.
- Developing novel prevention strategies is essential to further reduce infant mortality.
Abstract:
Despite the fall in numbers of unexpected infant deaths that followed the 'Back to Sleep' campaigns in the early 1990 s in the UK and many other countries, such deaths remain one of the largest single groups of deaths in the postneonatal period in many Western countries. Changes in the ways in which unexpected infant deaths are categorised by pathologists and coroners, and increasing reluctance to use the term 'sudden infant death syndrome', make assessment of nationally and internationally collected data on incidence potentially inaccurate and confusing. In this paper, we review current understanding of the epidemiology and aetiology of unexpected deaths in infancy, and current hypotheses on the pathophysiology of the processes that may lead to death. We also review interventions that have been adopted, with variable degrees of effectiveness in efforts to reduce the numbers of deaths, and new approaches that offer the possibility of prevention in the future.
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