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Changes in background characteristics and risk factors among SIDS infants in England: cohort comparisons from 1993 to 2020

OBJECTIVES: Using the National Child Mortality Database, this work aims to investigate background characteristics and risk factors in the sleeping environment associated with sudden infant death syndrome (SIDS) and compare the prevalence with previous English SIDS case–control studies. DESIGN: Cohor...

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Autores principales: Pease, Anna, Turner, Nicholas, Ingram, Jenny, Fleming, Peter, Patrick, Karen, Williams, Tom, Sleap, Vicky, Pitts, Kieren, Luyt, Karen, Ali, Becky, Blair, Peter
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10582842/
https://www.ncbi.nlm.nih.gov/pubmed/37832988
http://dx.doi.org/10.1136/bmjopen-2023-076751
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author Pease, Anna
Turner, Nicholas
Ingram, Jenny
Fleming, Peter
Patrick, Karen
Williams, Tom
Sleap, Vicky
Pitts, Kieren
Luyt, Karen
Ali, Becky
Blair, Peter
author_facet Pease, Anna
Turner, Nicholas
Ingram, Jenny
Fleming, Peter
Patrick, Karen
Williams, Tom
Sleap, Vicky
Pitts, Kieren
Luyt, Karen
Ali, Becky
Blair, Peter
author_sort Pease, Anna
collection PubMed
description OBJECTIVES: Using the National Child Mortality Database, this work aims to investigate background characteristics and risk factors in the sleeping environment associated with sudden infant death syndrome (SIDS) and compare the prevalence with previous English SIDS case–control studies. DESIGN: Cohort of SIDS in 2020 compared with a combined analysis of two case–control studies conducted in 1993–1996 and 2003–2006. SETTING: England, UK PARTICIPANTS: 138 SIDS deaths in 2020 compared with 402 SIDS deaths and 1387 age-equivalent surviving controls, combined from previous studies. RESULTS: The increased vulnerability of SIDS infants identified in previous studies has become more marked. The infants who died in 2020 were younger (median=66 days (IQR: 34–118) vs 86 days (IQR: 52–148), p=0.003) with an increased prevalence of low birth weight (30.5% vs 21.6%, p=0.04) and preterm births (29.6% vs 19.3%, p=0.012). The excess of socioeconomically deprived families, male infants and high levels of maternal smoking during pregnancy were still evident. Among recent deaths, fewer infants were put down or found on their side; however, there was no significant change in the proportion of infants who were put down (15.6% vs 14.6%, p=0.81) and found prone (40.4% vs 35.3%, p=0.37), despite population wide risk reduction advice over three decades. The proportional increase observed in 2003–2006 of half the deaths occurring while sleeping next to an adult was maintained in 2020, and for the vast majority (90%), this was in hazardous circumstances (adult had consumed alcohol, smoked, slept on a sofa, or the infant was premature or low birth weight and less than 3 months old). More deaths also occurred when there was a disruption in infant care routine compared with previous observations (52.6% vs 20.7%, p<0.001). CONCLUSIONS: A more targeted approach is needed with vulnerable families emphasising the importance of sleeping infants on their back and proactive planning infant sleep when there are disruptions to the normal routine, in particular to avoid hazardous co-sleeping.
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spelling pubmed-105828422023-10-19 Changes in background characteristics and risk factors among SIDS infants in England: cohort comparisons from 1993 to 2020 Pease, Anna Turner, Nicholas Ingram, Jenny Fleming, Peter Patrick, Karen Williams, Tom Sleap, Vicky Pitts, Kieren Luyt, Karen Ali, Becky Blair, Peter BMJ Open Epidemiology OBJECTIVES: Using the National Child Mortality Database, this work aims to investigate background characteristics and risk factors in the sleeping environment associated with sudden infant death syndrome (SIDS) and compare the prevalence with previous English SIDS case–control studies. DESIGN: Cohort of SIDS in 2020 compared with a combined analysis of two case–control studies conducted in 1993–1996 and 2003–2006. SETTING: England, UK PARTICIPANTS: 138 SIDS deaths in 2020 compared with 402 SIDS deaths and 1387 age-equivalent surviving controls, combined from previous studies. RESULTS: The increased vulnerability of SIDS infants identified in previous studies has become more marked. The infants who died in 2020 were younger (median=66 days (IQR: 34–118) vs 86 days (IQR: 52–148), p=0.003) with an increased prevalence of low birth weight (30.5% vs 21.6%, p=0.04) and preterm births (29.6% vs 19.3%, p=0.012). The excess of socioeconomically deprived families, male infants and high levels of maternal smoking during pregnancy were still evident. Among recent deaths, fewer infants were put down or found on their side; however, there was no significant change in the proportion of infants who were put down (15.6% vs 14.6%, p=0.81) and found prone (40.4% vs 35.3%, p=0.37), despite population wide risk reduction advice over three decades. The proportional increase observed in 2003–2006 of half the deaths occurring while sleeping next to an adult was maintained in 2020, and for the vast majority (90%), this was in hazardous circumstances (adult had consumed alcohol, smoked, slept on a sofa, or the infant was premature or low birth weight and less than 3 months old). More deaths also occurred when there was a disruption in infant care routine compared with previous observations (52.6% vs 20.7%, p<0.001). CONCLUSIONS: A more targeted approach is needed with vulnerable families emphasising the importance of sleeping infants on their back and proactive planning infant sleep when there are disruptions to the normal routine, in particular to avoid hazardous co-sleeping. BMJ Publishing Group 2023-10-13 /pmc/articles/PMC10582842/ /pubmed/37832988 http://dx.doi.org/10.1136/bmjopen-2023-076751 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
spellingShingle Epidemiology
Pease, Anna
Turner, Nicholas
Ingram, Jenny
Fleming, Peter
Patrick, Karen
Williams, Tom
Sleap, Vicky
Pitts, Kieren
Luyt, Karen
Ali, Becky
Blair, Peter
Changes in background characteristics and risk factors among SIDS infants in England: cohort comparisons from 1993 to 2020
title Changes in background characteristics and risk factors among SIDS infants in England: cohort comparisons from 1993 to 2020
title_full Changes in background characteristics and risk factors among SIDS infants in England: cohort comparisons from 1993 to 2020
title_fullStr Changes in background characteristics and risk factors among SIDS infants in England: cohort comparisons from 1993 to 2020
title_full_unstemmed Changes in background characteristics and risk factors among SIDS infants in England: cohort comparisons from 1993 to 2020
title_short Changes in background characteristics and risk factors among SIDS infants in England: cohort comparisons from 1993 to 2020
title_sort changes in background characteristics and risk factors among sids infants in england: cohort comparisons from 1993 to 2020
topic Epidemiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10582842/
https://www.ncbi.nlm.nih.gov/pubmed/37832988
http://dx.doi.org/10.1136/bmjopen-2023-076751
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