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Clinical Pediatrics
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Impact of Changes in Infant Death Classification on the Diagnosis of Sudden Infant Death Syndrome

Brooke M. Moore, MD, MPH

Department of Pediatrics, University of Minnesota Medical School, liff0005{at}umn.edu

Kathleen L. Fernbach, RN, PHN

Department of Pediatrics Children's Hospitals and Clinics of Minnesota, Minnesota Sudden Infant Death Center, Children's Hospitals and Clinics of Minnesota, Minneapolis, Minnesota

Marsha J. Finkelstein, MS

Center for Care Innovation and Research, Children's Hospitals and Clinics of Minnesota

Patrick L. Carolan, MD

Department of Pediatrics Children's Hospitals and Clinics of Minnesota, Minnesota Sudden Infant Death Center, Children's Hospitals and Clinics of Minnesota, Minneapolis, Minnesota

This study evaluates the hypothesis that a decline in sudden infant death syndrome in Minnesota is associated with increases in other categories of sudden unexpected infant death. Matched birth and death certificates, autopsy reports, and home visit questionnaires were reviewed for 722 sudden unexpected infant deaths that occurred from January 1, 1996 through December 31, 2002. Descriptive data and cause of death were recorded. Cause of death was compared for 2 periods: early (1996-1998) and late (2000-2002). The age of the infant at death, sex, race, and infant death rates were similar between the 2 periods ( P = .637). Sudden infant death syndrome declined by 50.1% (P < .001). Overlay deaths increased 235.5% (P < .01). Asphyxia related deaths increased 259.6% (P < .001). Injury-related deaths increased 840.0% (P < .001). A decline in sudden infant death syndrome in Minnesota was associated with increased deaths in categories that are asphyxial in nature and are potentially preventable.

Key Words: sudden infant death syndrome • sudden unexpected infant death • asphyxia • overlay • infant mortality • international classification of diseases • Back to Sleep campaign

This version was published on October 1, 2008

Clinical Pediatrics, Vol. 47, No. 8, 770-776 (2008)
DOI: 10.1177/0009922808316991


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H. C. Kinney and B. T. Thach
The Sudden Infant Death Syndrome
N. Engl. J. Med., August 20, 2009; 361(8): 795 - 805.
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