Abstract
BackgroundThe Sudden Unexpected Infant Death Syndrome (SUID) is one of the leading causes of mortality in the first year of life. The aim of this work was the retrospective evaluation of the incidence of SUID and the effectiveness of the multiagency approach to this phenomenon in the Tuscany Region.MethodsData were obtained from the regional registry of SUID cases in the period 2009–2019. The registry contains both sudden unexpected deaths in the first week of life (Sudden Unexpected Early Neonatal Deaths - SUEND), and those occurring after the first week up to 1 year of age (SUID).ResultsIn this timeframe a total of 73 sudden unexpected deaths occurred in our region; 32 were Unexplained (i.e. Sudden Infant Death Syndrome - SIDS), 24 Explained, 10 Undetermined, and 7 SUEND. Autopsies were performed in 91% of cases, and in 95% of these by three groups of selected pathologists according to our protocol.We found a low incidence of SUID (0.21 ‰), and SIDS deaths accounted for 0.1‰ of live births (48% of cases) with a high prevalence of infants of non-Italian ethnicity (38% of cases). Bereaved families were able to receive psychological support from mental health professionals and have contact with the family association, Seeds for SIDS. Audits were organized when post-mortem examinations were not carried out or carried out incorrectly in procedural terms, and when the diagnosis was particularly uncertain.ConclusionsThis paper first provides data on SUID mortality based on complete post-mortems in an Italian region. According to these findings we can state that our approach is effective both in terms of correctly performed autopsies and support for bereaved families. Future efforts are necessary to further reduce the incidence of SUID especially among non- Italian infants. An improvement action is also recommended for ensuring a more accurate and consistent picture of the circumstances of death.The final approval of the National Protocol for the management of SUID cases is therefore strongly advocated in order to improve surveillance in this specific field and abolish disparities among the Italian regions.
Highlights
The Sudden Unexpected Infant Death Syndrome (SUID) is one of the leading causes of mortality in the first year of life
The timely and correct performing of autopsies in every SUID case represents a crucial point because it allows for precise monitoring of the phenomenon, providing an important contribution to research and a correct and empathetic communication of the results is highly supportive for bereaved families [3] [4]
There were 7 cases of Sudden Unexpected Early Neonatal Death (SUEND), all of which were subjected to autopsies performed by the same group of selected pathologists as recommended [8]
Summary
The Sudden Unexpected Infant Death Syndrome (SUID) is one of the leading causes of mortality in the first year of life. In an open-ended survey conducted in the USA by the American Academy of Pediatrics (AAP) Committee on Pediatric Research, the reduction of sudden infant deaths obtained with the “Back to Seep” campaigns was listed in second place among the seven great achievements in paediatrics over the last 40 years [1]. This emerged because Sudden Unexpected Infant Death (SUID) is one of the leading causes of mortality in the first year of life and have a devasting psychological impact on bereaved families. Risk factors for SIDS are the same as those identified for SUID, the reduce the risk campaigns have been renamed “Safe to Sleep” in order to stress that SIDS reduction strategies are able to reduce all sleep-related deaths
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