Abstract
Gilbert NL, Fell DB, Joseph KS, Liu S, León JA, Sauve R, for the Fetal and Infant Health Study Group of the Canadian Perinatal Surveillance System. Temporal trends in sudden infant death syndrome in Canada from 1991 to 2005: contribution of changes in cause of death assignment practices and in maternal and infant characteristics. Paediatric and Perinatal Epidemiology 2012; 26: 124–130.The rate of sudden infant death syndrome (SIDS) declined significantly in Canada and the US between the late 1980s and the early 2000s. In the US, this decline was shown to be due in part to a shift in diagnosis, as deaths from accidental suffocation and strangulation in bed and from other ill-defined and unspecified cause increased concurrently. This study was undertaken to determine whether there was such a shift in diagnosis from SIDS to other causes of death in Canada, and to quantify the true temporal decrease in SIDS. Cause-specific infant death rates were compared across three periods: 1991–95, 1996–2000 and 2001–05 using the Canadian linked livebirth-infant death file. The temporal decline in SIDS was estimated after adjustment for maternal and infant characteristics such as maternal age and small-for-gestational age using logistic regression. Deaths from SIDS decreased from 78.4 [95% confidence interval (CI) 73.4, 83.4] per 100 000 livebirths in 1991–95, to 48.5 [95% CI 44.3, 52.7] in 1996–2000 and to 34.6 [95% CI 31.0, 38.3] in 2001–05. Mortality rates from other ill-defined and unspecified causes and accidental suffocation and strangulation in bed remained stable. The temporal decline in SIDS between 1991–95 and 2001–05 did not change substantially after adjustment for maternal and infant factors. It is unlikely that the temporal decline of SIDS in Canada was due to changes in cause-of-death assignment practices or in maternal and infant characteristics.
Highlights
Sudden infant death syndrome (SIDS) is defined as ‘the sudden death of an infant aged less than one year, which remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene, and review of
We examined whether changes in maternal and infant characteristics such as maternal age, parity, small-for-gestational age (SGA) and other factors could explain any part of the decline in SIDS
Other causes of death such as asphyxia and respiratory arrest, ill-defined and unspecified cause, accidental suffocation and strangulation and abandonment/maltreatment showed no change between 1991–95 and 2001–05, other suffocation and strangulation increased from 1.2 to 2.4 per 100 000 livebirths
Summary
Sudden infant death syndrome (SIDS) is defined as ‘the sudden death of an infant aged less than one year, which remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene, and review of. In Canada (excluding Ontario), the rate of SIDS decreased from 0.6 to 0.3 deaths per 1000 livebirths between 1999 and 2004.4 SIDS remains the fourth leading cause of infant death – in 2004, SIDS accounted for 5.0% of all infant deaths in Canada (excluding Ontario).[4]. Several explanations have been proposed for this decline in SIDS These include parents’ compliance with public health recommendations to reduce the risk of Paediatric and Perinatal Epidemiology, 2012, 26, 124–130. Deaths from other ill-defined and unspecified causes, accidental suffocation and strangulation in bed, and other accidental suffocation and strangulation rose by approximately 6.2, 3.4, and 0.7 per 100 000 livebirths, respectively, for a total increase of 10.3 per 100 000.12
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