Abstract

BackgroundRisk factors for Sudden Unexpected Death in Infancy (SUDI) are well described, and such cases are now investigated according to standard protocols. In London, Project Indigo of the Metropolitan Police provides a unique, detailed framework for such data collection. We investigate such data to provide a contemporary account of SUDI in a large city and further link data to publically available datasets to investigate interactions with social factors.MethodsRetrospective analysis of data routinely collected by the Metropolitan Police Service in all cases of non-suspicious SUDI deaths in London during a six year period.ResultsSUDI deaths are associated with markers of social deprivation in London. A significant proportion of such deaths are associated with potentially modifiable risk factors such as cigarette smoking and co-sleeping, such behaviour also being associated with social factors, including accommodation issues.ConclusionsRoutinely collected data provide valuable insight into patterns and associations of mortality, with SUDI remaining a significant issue in London. Risk factors include social disadvantage, which may manifest in part by affecting behavioural patterns such as co-sleeping and public health interventions to reduce rates require significant social modification.

Highlights

  • Risk factors for Sudden Unexpected Death in Infancy (SUDI) are well described, and such cases are investigated according to standard protocols

  • Deaths are categorised as medically explained, unexplained, or unascertained based on the pathologist’s opinion given in the postmortem report provided at the time of investigation. As these data were collected from a number of pathologists at different hospitals, and interpretation and use of terms in infant death is known to vary between practitioners, the term ‘unexplained’ in this context may not be directly equivalent to Sudden Infant Death Syndrome (SIDS) or SUDI

  • It is not possible to describe the full range of data collected in this manuscript, and this study focuses on risk factors for unexplained infant death highlighted in previous studies; co-sleeping, lifestyle factors, and social deprivation

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Summary

Introduction

Risk factors for Sudden Unexpected Death in Infancy (SUDI) are well described, and such cases are investigated according to standard protocols. We investigate such data to provide a contemporary account of SUDI in a large city and further link data to publically available datasets to investigate interactions with social factors. In England, the NHS Outcomes Framework (14/2014) provides key outcomes including Domain One (‘Preventing people from dying prematurely’) including ‘Potential Years of Life Lost (PYLL) from causes considered amenable to healthcare in children and young people’ (1aii) [2], and highlights reducing deaths in babies and children as an improvement area (1.6i) [2], shared with the public health outcomes framework (4.1) [6,7,8]

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