Background: In California, postneonatal deaths (28-364 days of age) diagnosed as Sudden Infant Death Syndrome (SIDS) have declined 63.6% between 1990 and 1998. During this period, the consistency of SIDS diagnosis has been questioned and some have suggested the possibility that the decrease in SIDS mortality is a result of a shift in diagnosis rather than a true decrease in SIDS deaths. The purpose of this study is to evaluate California postneonatal deaths in order to identify any shifts in ICD-9 coding from SIDS to other classifications for 1990-1998. Methods: California’s postneonatal death rates (deaths/1,000 live births) were evaluated by cause of death (ICD-9 codes) for 1990 and 1998. Data were obtained from California birth and death records. Postneonatal death counts were further analyzed by cause of death for diagnoses where SIDS (ICD-9 code 798.0) deaths were most likely to have been shifted. Results: Between 1990 and 1998, SIDS deaths decreased from 676 in 1990 to 246 in 1998. Most other death classifications analyzed also declined. There was only a slight increase in diagnoses of other unknown and unspecified causes (ICD-9 code 799.9) from 62 in 1990 to 89 in 1998. Conclusions: SIDS rates have declined from 1990-1998, as have many other causes of postneonatal mortality. We found no evidence that shifting diagnosis accounts for the decrease in SIDS. Other factors, such as changes in sleep position, are likely to be responsible. Implications: Our findings suggest that the reduction in SIDS rates is real.
Learning Objectives: 1. Recognize that postneonatal deaths diagnosed as SIDS have declined in California. 2. Identify other diagnoses where SIDS could potentially be shifted. 3. Recognize that the decline in SIDS is not a result of shifting in diagnosis
Keywords: Infant Mortality, SIDS
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.