Classification of sleep‐related sudden unexpected death in infancy: a national survey

Joanna Garstang, Marta Cohen, Edwin A. Mitchell, Peter Sidebotham

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Abstract

Aim: To identify how British Child Death Overview Panels (CDOPs) and paediatric pathologists classify cause of death for sleep-related Sudden Unexpected Death in Infancy (SUDI). To determine compliance with national requirements for SUDI investigation. 


Methods: Electronic survey of CDOPs and pathologists using three vignettes of SUDI cases illustrating: accidental asphyxia, typical Sudden Infant Death Syndrome (SIDS) and SIDS with co-sleeping. 


Results: Thirty-eight (41%) of 92 CDOPs returned questionnaires, and 32 were complete. Thirteen (14%) of 90 pathologists returned complete questionnaires. Thirty-one (97%) CDOPs and 7 (53%) pathologists agreed with the cause of death in the accidental asphyxia case; 24 (75%) CDOPs and 9 (69%) pathologists in the typical SIDS case; and 11 (34%) CDOPs and 1 (8%) pathologist in the co-sleeping SIDS case. Pathologists used the terms SUDI or unascertained as the cause of death for the accidental asphyxia case (46%) and the co-sleeping SIDS case (77%). These terms were used by CDOPs for the typical SIDS case (25%) and the co-sleeping SIDS case (41%). Seventeen (46%) CDOPs reported compliance with guidelines for investigation in more than 75% of cases. 


Conclusion: There is wide variation in classification of deaths, with only limited agreement between CDOPs and pathologists. The terms SIDS and accidental asphyxia are underused, even in typical cases.

Original languageEnglish
Pages (from-to)869-874
JournalActa Paediatrica
Volume110
Issue number3
Early online date12 Jul 2020
DOIs
Publication statusPublished - Mar 2021

Bibliographical note

Funding Information:
JG has received research grants from the National Institute of Health Research (DRF 2010‐0345) and is an executive committee member of the National Network of CDOPs.

Funding Information:
The corresponding author had full access to all data in the study and had final responsibility for the decision to submit for publication. JG has received research grants from the National Institute of Health Research (DRF 2010-0345) and is an executive committee member of the National Network of CDOPs. PS is a trustee of the Lullaby Trust and the Association of Child Protection Professionals. He is a member of the National Panel for Child Safeguarding Practice Reviews. PS contributed to the development of national guidelines for both SUDI investigation and child death review.

Keywords

  • accidental asphyxia
  • cause of death
  • child death review
  • sudden infant death syndrome
  • sudden unexpected death in infancy

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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