Infant Mechanical Suffocation Deaths in the United States, 1980–1997

Drago, Dorothy A.; Dannenberg, Andrew L.

doi:10.1542/peds.103.5.e59

Cited by 110 publications

(94 citation statements)

References 11 publications

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“…Studies from the United States suggest an increased risk for accidental suffocation for infants bedsharing on adult beds. 2,6 Most of these deaths involve either overlaying or infants found wedged. The increased risk for SIDS among bedsharing infants including AA infants is well documented.…”

Section: Discussionmentioning

confidence: 99%

Racial Disparity and Modifiable Risk Factors Among Infants Dying Suddenly and Unexpectedly

Unger

Kemp²,

Wilkins

et al. 2003

Pediatrics

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ABSTRACT. Background. Racial disparity in rates of death attributable to sudden infant death syndrome (SIDS) has been observed for many years. Despite decreased SIDS death rates following the "Back to Sleep" intervention in 1994, this disparity in death rates has increased. The prone sleep position, unsafe sleep surfaces, and sharing a sleep surface with others (bedsharing) increase the risk of sudden infant death. The racespecific prevalence of these modifiable risk factors in sudden unexpected infant deaths-including SIDS, accidental suffocation (AS), and cause of death undetermined (UD)-has not been investigated in a populationbased study. Death rates attributable to AS and UD are also higher in African Americans (AAs) than in other races (non-AA). The potential contribution of unsafe sleep practices to this overall disparity in death rates is uncertain.Objective. The objective of this study was to compare death rates attributable to SIDS and related causes of death (AS and UD) in AA and non-AA infants and the prevalence of unsafe sleep practices at time of death. Our hypothesis was that there is a large racial disparity in these modifiable risk factors at the time of death, and that public awareness of this could lead to improved intervention strategies to reduce the disparity in death rates.Methods. In this population-based study, we retrospectively reviewed death-scene information and medical examiners' investigations of deaths in St Louis City and County between January 1, 1994, and December 31, 1997. The deaths of all infants <2 years old with the diagnoses of SIDS, AS, or UD were included. Sleep surfaces other than those specifically designed and approved for infant use were termed nonstandard (adult beds, sofas, etc). Denominators for our rate estimates were the number of births (AA and non-AA) in St Louis City and County during the study period.Results. The deaths of 119 infants were studied (81 AA and 38 non-AA). SIDS rates were much higher in AA than non-AA infants (2.08 vs 0.65 per 1000 live births), as was the rate of AS (0.47 vs 0.06). There was a trend for increased deaths diagnosed as UD in AA infants (0.36 vs 0.06). Bedsharing deaths were nearly twice as common in AAs (67.1% vs 35.1% of deaths), as were deaths on nonstandard sleep surfaces (79.0% vs 46.0%). Forty-nine percent (49.1%) of all infants who died while bedsharing were found on their backs or sides compared with 20.4% of infants who were not bedsharing. Overall, the fraction of infants found in these nonprone positions was not different for AA infants and non-AA infants (43.3% vs 38.5%). In AA and non-AA infants, factors that greatly increase the risk of bedsharing, such as sofa sharing or all-night bedsharing, were present in all or many bedsharing deaths.Conclusion. Among AA infants dying suddenly and unexpectedly, the high prevalence of nonstandard bed use and bedsharing may underlie, in part, their increased death rates. Public health messages tailored for the AA community have stressed first and foremost using nonprone sleep pos...

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Section: Discussionmentioning

confidence: 99%

Racial Disparity and Modifiable Risk Factors Among Infants Dying Suddenly and Unexpectedly

Unger

Kemp²,

Wilkins

et al. 2003

Pediatrics

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“…Most USA and other western infants die from SIDS or from fatal accidents during solitary sleep outside the supervision of a committed adult. 24 Moreover, the overwhelming number of suspected accidental overlays or fatal accidents occur not within breast feeding-bedsharing communities but in urban poverty, where multiple independent SIDS risk 'factors' converge and bottle feeding rather than breast feeding predominates. Additional adverse risk 'factors' associated with bedsharing in high-risk populations are maternal smoking, infants placed to sleep on pillows or under duvets, with other children and co-sleeping with infants on sofas, waterbeds or couches.…”

Section: Introductionmentioning

confidence: 99%

Why babies should never sleep alone: A review of the co-sleeping controversy in relation to SIDS, bedsharing and breast feeding

McKenna

McDade

2005

Paediatric Respiratory Reviews

209

159

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“…3 Previous studies have investigated infant mortality attributed to suffocation and strangulation in cribs and adult beds, 4 risk factors for sudden unexpected death in infancy, 5,6 injuries attributed to crib bumper pads, 7,8 and deaths attributed to hanging, wedging, and positional asphyxia. [9][10][11] However, nonfatal injuries associated with cribs have been largely overlooked in research, although these events are far greater in number than fatalities associated with cribs and can result in serious morbidity. This is the first nationally representative study to examine the epidemiology of injuries to young children associated with cribs, playpens, and bassinets treated in emergency departments in the United States.…”

mentioning

confidence: 99%

Injuries Associated With Cribs, Playpens, and Bassinets Among Young Children in the US, 1990–2008

et al. 2011

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WHAT'S KNOWN ON THIS SUBJECT:Previous research has focused on infant mortality attributed to suffocation and strangulation in the crib environment. No studies have investigated both fatal and nonfatal crib-related injuries. WHAT THIS STUDY ADDS:This study is the first to use a nationally representative sample to investigate injuries among young children associated with cribs, playpens, and bassinets. abstract OBJECTIVE: To describe the epidemiology of injuries related to cribs, playpens, and bassinets among young children in the United States. METHODS:A retrospective analysis was done using data from the National Electronic Injury Surveillance System for children younger than 2 years of age treated in emergency departments in the United States from 1990 through 2008 for an injury associated with cribs, playpens, and bassinets. RESULTS:An estimated 181 654 (95% confidence interval: 148 548 -214 761) children younger than 2 years of age were treated in emergency departments in the United States for injuries related to cribs, playpens, and bassinets during the 19-year study period. There was an average of 9561 cases per year or an average of 12.1 injuries per 10 000 children younger than 2 years old per year. Most of the injuries involved cribs (83.2%), followed by playpens (12.6%) and bassinets (4.2%). The most common mechanism of injury was a fall from a crib, playpen, or bassinet, representing 66.2% of injuries. Soft-tissue injuries comprised the most common diagnosis (34.1%), and the most frequently injured body region was the head or neck (40.3%). Patients with fractures were admitted 14.0% of the time, making them 5.45 (95% confidence interval: 3.80 -7.80) times more likely to be hospitalized than patients with other types of injury. Children younger than 6 months were 2.97 (95% confidence interval: 2.07-4.24) times more likely to be hospitalized than older children. CONCLUSIONS:This study is the first to use a nationally representative sample to examine injuries associated with cribs, playpens, and bassinets. Given the consistently high number of observed injuries, greater efforts are needed to ensure safety in the design and manufacture of these products, ensure their proper usage in the home, and increase awareness of their potential dangers to young children.

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Infant Mechanical Suffocation Deaths in the United States, 1980–1997

Cited by 110 publications

References 11 publications

Racial Disparity and Modifiable Risk Factors Among Infants Dying Suddenly and Unexpectedly

Racial Disparity and Modifiable Risk Factors Among Infants Dying Suddenly and Unexpectedly

Why babies should never sleep alone: A review of the co-sleeping controversy in relation to SIDS, bedsharing and breast feeding

Injuries Associated With Cribs, Playpens, and Bassinets Among Young Children in the US, 1990–2008

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