Cause of Infant Death May Be Underestimated, Research Reports

Main Category: Pediatrics / Children's Health
Article Date: 15 May 2005 - 20:00 PDT

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In Arizona, sleep associated deaths are the leading cause of death for infants. New information on infants who died during sleep from SIDS, suffocation or asphyxiation suggests that most of these deaths may be preventable. In 1994, The Back to Sleep Campaign began educating parents, caregivers and physicians on safe sleep techniques and has been credited with a 50% reduction in SIDS.

Besides promoting back to sleep as the safest sleep position, the Campaign also promotes awareness on sleeping hazards such as being placed on soft bedding, dangers in the infant's sleep environment such as quilts, pillows and certain bed sharing arrangements with other children or adults. These sleeping hazards result in deaths from suffocation or asphyxiation. These non-SIDS deaths, however, have not been tracked together with SIDS deaths to determine whether the Campaign effectively reduces all preventable infant sleep-associated deaths.

A recent study shows that 72% of Arizona infants who died from sleep-associated deaths may have been prevented. Researchers from Maricopa Medical Center, Anu Partap, MD MPH and Justin Sales, MD MPH, studied the overall problem of infants dying due to unsafe sleep practices to determine whether the current Back to Sleep Campaign is sufficient in reducing infant deaths.

Using data from the Arizona Department of Health Service's Child Fatality Review Program, the researchers reviewed all sleep associated deaths of infants in Arizona between 1999 and 2001. They found that 134 infants died from SIDS or sleep hazards resulting in suffocation or asphyxiation. The study focused on 109 complete records of infant deaths, and of these, 72% died from either high risk sleep position or hazards addressed in the Back to Sleep Campaign. These deaths may have been preventable.

The research shows the need to promote a broadened and stronger Back to Sleep Campaign that emphasizes Safe Infant Sleep. Dr. Partap, lead researcher and pediatrician, believes "If we just focus on SIDS rates alone, it is easy to underestimate the on-going problem of infants dying from risks associated with their sleep environment." Dr. Partap explains, "For Arizona, the research reveals that SIDS and sleep environment hazards together are the leading cause of infant death and that most of these may have been preventable."

Dr. Partap applauds the Back to Sleep Campaign for its accomplishments in promoting education for parents and caregivers on safe sleep positions and a healthy sleep environment for babies. While the Campaign has helped to reduce SIDS death by 50 percent, the study suggests that the time has come to reframe the Campaign so it strongly emphasizes both sleep position and sleep environment. Public health also must track infant mortality differently to measure the effectiveness of current outreach strategies. "We can't just focus on one aspect of infant sleep to determine if we are reducing the number of babies dying from potentially preventable causes," states Dr. Partap.

The study also revealed demographic disparities in Arizona. African American infants had a 5x higher rate of dying from a potentially preventable sleep-associated cause of death and infants with Medicaid coverage had a 1.5x higher rate than expected. In addition to refocusing the Campaign on sleep hazards, the Campaign needs to more effectively reach out to the African American and Medicaid population.

Anu Partap, MD MPH, Director of the Arizona Center for Community Pediatrics, lead the research group from Maricopa Medical Center, which includes co-investigators and authors Justin W. Sales, MD MPH, Nilay Kavathi, and Curt Bay, PhD. Dr. Sales will present the team's research at the Pediatric Academic Societies Annual Meeting May 14, 2005 in Washington D.C at the Washington Convention Center.

Maricopa Medical Center is part of the Maricopa Integrated Health System, which includes the Maricopa Medical Center, a 449-bed teaching hospital with a Level 1 trauma center and pediatric trauma services. The hospital is also home to the Arizona Burn Center, the second largest burn treatment facility of its kind in the U.S. Other associated facilities include two inpatient behavioral health treatment centers, an HIV-AIDS clinic and 11 family health clinics.

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