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Health Indicator Report of Sudden Unexpected Infant Death (SUID)

Even after a thorough investigation, it can be hard to tell SIDS apart from other sleep-related infant deaths such as overlay or suffocation by soft bedding. This is because these deaths are often unwitnessed and there are no tests to tell SIDS apart from suffocation. To complicate matters, people who investigate SUIDs may report cause of death in different ways and may not include enough information about the circumstances of the event from the death scene.[https://www.cdc.gov/sids/AboutSUIDandSIDS.htm ^1^]

Notes

Confidence limits are not available for the U.S. data.

Data Sources

  • Birth Certificate Database, Office of Vital Statistics and Registry, New Jersey Department of Health
  • Centers for Disease Control and Prevention, National Center for Health Statistics. Linked Birth/Infant Death Records, CDC WONDER On-line Database accessed at [http://wonder.cdc.gov/lbd.html]
  • Linked Infant Death-Birth Database, Center for Health Statistics, New Jersey Department of Health

Definition

Sudden unexpected infant death (SUID) is the death of an infant less than 1 year of age that occurs suddenly and unexpectedly, and whose cause of death is not immediately obvious before investigation. ICD-10 codes: R95 (SIDS), R99 (unknown cause), and W75 (accidental suffocation and strangulation in bed)

Numerator

Number of deaths in the first year of life with Sudden Unexpected Infant Death as the underlying cause of death

Denominator

Total number of live births in the same year

Healthy People Objective: Infant deaths from sudden unexpected infant deaths (includes SIDS, Unknown Cause, Accidental Suffocation, and Strangulation in Bed)

U.S. Target: 0.84 infant deaths per 1,000 live births

How Are We Doing?

In New Jersey, there was a 29% decline in the SUID rate from 0.68 in 2000-2002 to 0.48 in 2012-2014, however the rate rose in 2013-2015 and further years of data are needed to determine if this was a true increase or an anomaly. As with all infant deaths, the rate of SUID among infants of Black mothers is significantly higher than among other racial/ethnic groups. In 2013-2015, the SUID rate among Blacks (1.6 per 1,000 live births) was four times the rate among Whites and Hispanics (0.4). Disparities are associated in part with disparities in social determinants of health, including measures of socioeconomic status and access to healthcare, in prematurity and low birth weight, and in infant care practices that elevate the risk of SUID. The latter include, but are not limited to, bed-sharing with infants, non-supine sleep placement, and household exposure to tobacco smoke. Of note, however, in contrast to a national rise in the percentage of infants who usually slept in a shared bed, particularly in families of Black infants[http://jamanetwork.com/journals/jamapediatrics/fullarticle/1746117 ^1^], New Jersey experienced a decline of 31.4%[http://www.nj.gov/health/fhs/maternalchild/outcomes/prams/ ^2^] in the usual use of bed-sharing in this population from 2003 to 2010, the period comparable to the national study.

How Do We Compare With the U.S.?

New Jersey's SUID rate of 0.6 deaths per 1,000 live births falls well below the national rate of 0.9 in 2013-2015. New Jersey is tied with five other states for the third lowest SUID rate in that 3-year period.

What Is Being Done?

The "[https://www.nichd.nih.gov/sts/Pages/default.aspx Safe to Sleep]" campaign to reduce the risk of SIDS and other sleep-related infant deaths describes the safest sleep environment for infants up 12 months of age. In addition to placing infants on their backs to sleep, the [http://pediatrics.aappublications.org/content/early/2016/10/20/peds.2016-2938 guidelines] recommend that caregivers avoid having the infant bed share with a sleeping person and avoid placing the infant on a sofa or chair to sleep; remove loose bedding, pillows, quilts, soft objects, and bumpers from the infant's sleep area; use a firm mattress that fits the crib space and cover it only with a tightly fitted sheet; avoid overheating the infant; and avoid exposure to tobacco smoke. Although bed sharing is not recommended, room sharing with the baby is strongly advised so that the parent can be close by the infant. Breastfeeding is also recommended and while the infant may be brought into bed for feeding and comforting, the American Academy of Pediatrics (AAP) recommends that the infant be returned to a near-by safety-approved crib once the parent is ready to sleep. The AAP recommends that parents consider using a pacifier but avoid the use of clips or strings to attach it to the infant's clothing as these can pose a suffocation risk. Tummy time when the infant is awake and supervised is also recommended to facilitate motor development. The AAP recommends the use of cribs, bassinets, and portable cribs that meet current standards of safety from the [https://www.cpsc.gov/ Consumer Product Safety Commission] (800-638-2772). The [http://www.rwjms.rutgers.edu/sids/index.html SIDS Center of New Jersey] (SCNJ) serves the state's mission to provide multilingual and culturally, racially, and ethnically sensitive education on safe infant sleep to caregivers and health and social service providers and institutions. SCNJ collaborates with physicians, nurses, social service providers, child care providers, health care systems, social service organizations, government agencies, community organizations, and faith-based and educational institutions with allied public health missions related to infant health and safety and the reduction of disparities in health. It identifies and addresses barriers to compliance. Three of SCNJ's initiatives are * Nurses LEAD the Way, presented at NJ's birthing hospitals, which has resulted in improvements in knowledge about safe sleep and in education policies and procedures related to the provision of this information to families; * Neighborhoods LEAD the Way, which reaches into communities at highest risk to address the challenges of racial disparity; and * DCP&P LEADS the Way, a program to bring safe sleep guidance to all local NJ Division of Child Protection and Permanency offices to promote education and address potential barriers in higher risk populations. [[br]] SCNJ provides educational materials and maintains an educational website on safe infant sleep. SCNJ also targets specific groups of caregivers, such as grandparents; collaborates with Mom's Quit Connection to address the major risk factor of household smoke; and provides information to the state's pediatricians on such initiatives as Keep It Up, an effort by SCNJ to encourage discussions of safe sleep to occur at all pediatric visits in the first year rather than just at the first. Other initiatives include a statewide conference on racial disparity and a school-based community education project. SCNJ provides bereavement services to families whose infants have died suddenly and unexpectedly and studies risk factors associated with these deaths. SCNJ was represented on the national Expert Leadership Group of the Maternal Child Health Bureau-funded project to develop the next era of guidance for safe infant sleep.

Available Services

Sudden Infant Death Syndrome Center of New Jersey (SCNJ) Hotline: 800-545-7437 To obtain a Hospital Safe Sleep Tool Kit, the American Academy of Pediatrics safe infant sleep guidelines, and SIDS Center safe sleep materials: [http://www.rwjms.rutgers.edu/sids] NJ Department of Children and Families: [http://njsafesleep.com/main/ NJ Safe Sleep]

Health Program Information

National Institutes of Health "Safe to Sleep" campaign: [http://www.nichd.nih.gov/sids/]
Page Content Updated On 12/14/2017, Published on 05/18/2018
The information provided above is from the Department of Health's NJSHAD web site (https://nj.gov/health/shad). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Thu, 21 June 2018 21:50:18 from Department of Health, New Jersey State Health Assessment Data Web site: https://nj.gov/health/shad ".

Content updated: Wed, 23 May 2018 05:01:08 EDT