Sudden unexpected infant deaths (SUID) accounted for 1 in 3 postneonatal deaths in 2010. Sudden infant death syndrome and accidental sleep-related suffocation are among the most frequently reported types of SUID. The causes of these SUID usually are not obvious before a medico-legal investigation and may remain unexplained even after investigation. Lack of consistent investigation practices and an autopsy marker make it difficult to distinguish sudden infant death syndrome from other SUID. Standardized categories might assist in differentiating SUID subtypes and allow for more accurate monitoring of the magnitude of SUID, as well as an enhanced ability to characterize the highest risk groups. To capture information about the extent to which cases are thoroughly investigated and how factors like unsafe sleep may contribute to deaths, CDC created a multistate SUID Case Registry in 2009. As part of the registry, the Centers for Disease Control and Prevention developed a classification system that recognizes the uncertainty about how suffocation or asphyxiation may contribute to death and that accounts for unknown and incomplete information about the death scene and autopsy. This report describes the classification system, including its definitions and decision-making algorithm, and applies the system to 436 US SUID cases that occurred in 2011 and were reported to the registry. These categories, although not replacing official cause-of-death determinations, allow local and state programs to track SUID subtypes, creating a valuable tool to identify gaps in investigation and inform SUID reduction strategies.
Classification System for the Sudden Unexpected Infant Death Case Registry and its Application
FINANCIAL DISCLOSURE: Ms Covington’s agency, the Michigan Public Health Institute, received funds from EGS that originated at the Centers for Disease Control and Prevention in the amount of $233,076.48 for the period April 1, 2009 to May 31, 2011, to develop and support components of the SUID Case Registry described in the article (reference 09FED907750, contract GS07F67053R). The other authors have indicated they have no financial relationships relevant to this article to disclose.
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Carrie K. Shapiro-Mendoza, Lena Camperlengo, Rebecca Ludvigsen, Carri Cottengim, Robert N. Anderson, Thomas Andrew, Theresa Covington, Fern R. Hauck, James Kemp, Marian MacDorman; Classification System for the Sudden Unexpected Infant Death Case Registry and its Application. Pediatrics July 2014; 134 (1): e210–e219. 10.1542/peds.2014-0180
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