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New Classification Scheme for Sudden Unexpected Infant Death :

December 9, 2019

Previous studies have taught us to move away from the term “sudden infant death syndrome” or SIDS as an overarching term for an unexpected infant death. Instead we have adopted the term “sudden unexpected infant death” or SUID as one that includes multiple etiologies for an infant’s unexpected passing.

Previous studies have taught us to move away from the term “sudden infant death syndrome” or SIDS as an overarching term for an unexpected infant death. Instead we have adopted the term “sudden unexpected infant death” or SUID as one that includes multiple etiologies for an infant’s unexpected passing. Is there a better way to further classify SUID, which would give more insight into the cause of death?  Lavista Ferres et al (10.1542/peds.2019-1637) share with us a serial cross-sectional analysis of linked national birth and death data from the Centers for Disease Control and Prevention from 2003-2013. The authors found 37,624 cases of SUID in 41 million births. They classified the cases into two groups—those that are sudden unexpected early neonatal deaths (SUEND), occurring form from 0 to 6 days of age, and postperinatal SUID, from 7 to 365 days. The authors found a variety of differences in the characteristics of these two groups and also in the description of the deaths. As a result, they call for SUEND to be considered a separate and discrete entity from postperinatal SUID.

Is this a good idea? To answer that, we invited Dr. Richard Goldstein from Boston Children’s Hospital, whose research focuses on SUID prevention, to share his thoughts in an accompanying commentary (10.1542/peds.2019-3212).  He notes the importance of these findings but cautions us to recognize the ambiguity of determining “live birth” on day zero or at the time of labor and delivery, worrying that infants might not be appropriately categorized using the proposed strategy.  Does this mean we should not use the classification proposed by Lavista Ferres et al? Dr Goldstein suggests we should consider this approach but use it as a starting point to better understand the epidemiology of SUID and what could potentially be done to reduce the risk of SUID.  Read both the study and commentary and share your thoughts with us regarding the findings and the implications of this research.

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