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The CESDI SUDI study: Cot deaths outside the cot
Abstract   Peer reviewed

The CESDI SUDI study: Cot deaths outside the cot

P S Blair, P J Fleming, I J Smith, M Ward Platt, Jeanine Young, P Nadin, P J Berry and J Golding
Proceedings of the 6th SIDS International Conference, p.56
SIDS International Conference, 6th (Auckland, New Zealand, 08-Feb-2000–11-Feb-2000)
2000
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http://www.ispid.org/fileadmin/user_upload/textfiles/SIDSI2000_handbook1Feb.pdfView
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Abstract

Paediatrics and Reproductive Medicine sudden infant death syndrome
Although sudden infant death syndrome (SIDS) is referred to as 'cot' death, a proportion of these deaths occur outside this environment. The prevalence and risk associated with the different sleeping environments in which these deaths were discovered has been investigated. Methods A three year case-control study conducted in 5 of 14 Health Regions in England (population ~ 17 million, 500,000 livebirths). Parental interviews were conducted for each infant who died and for four controls matched for age and time of sleep. Ascertainment was over 90% [1][2]. This analysis includes 325 SIDS and 1300 matched controls. Results Just over half the deaths (54.7%) were discovered in a cot compared to threequarters of the control infants (74.3%) who woke up in a cot after the reference sleep. A similar proportion were found in a pram, bouncy chair or car seat (7.2% SIDS vs 8.1% controls). Using these 'baby-designed' environments as a reference group there was a significant risk associated with infants found in bed with the parents (25.8% SIDS vs 14.7% controls, OR=2.47 [95% CI: 1.74- 3.52] this will be dealt with in a separate presentation) and an even greater risk for those infants who slept in an adult bed without the parents (4.7% vs 0.3%, OR=18.99 [95% CI: 4.84-72.92]). Of these 15 deaths, 14 were in a room unattended, 2 of these infants were discovered on the floor, 2 under the bedcovers at the bottom of the bed and 2 were extremely overwrapped. A highly significant risk was also associated with infants found sleeping with an adult on a sofa (6.3% vs 0.5%, OR=23.96 [95% CI: 7.08- 81.10]). The narrative account suggests that for 4 of these 20 deaths the infant was wedged between the parent and the back of the sofa. Of the 10 SIDS mothers and 10 partners, 7 had not intended to fall asleep on the sofa, but for 9 this practice was not unusual. In 5 of these deaths the co-sleeping parent had consumed up to 2 units of alcohol and a further 3 had consumed much more than this. There was no risk associated with infants who slept on a sofa alone (1.3% vs 2.2%, OR=0.68 [95% CI: 0.22-2.14]). Conclusions In this study more than 1 in 10 deaths occurred whilst the infant slept alone on an adult bed or slept with an adult on the sofa. These deaths could be avoided if parents are issued with the appropriate advice.

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