3124.0: Monday, November 13, 2000 - 3:00 PM

Abstract #9935

Increase in the proportion of Sudden Infant Death Syndrome (SIDS) deaths reported in out of home settings (OHS) in California: 1992-1996

Elizabeth Adams, PhD1, Kim Wells, BS1, Rugmini Shah, MD1, Iyasu Solomon, MD, MPH2, and Gilberto Chavez, MD, MPH1. (1) Maternal and Child Health Branch, California Department of Health Services, 714 P Street, Room 476, Sacramento, CA 95814, (916) 657-2888, eadams@dhs.ca.gov, (2) Division of Reproductive Health, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, MS K-23, Atlanta, GA 30341

Background: Between 1992 and 1996, concurrent with a shift from prone to non-prone infant positioning, SIDS mortality has declined. Many California infants are regularly cared for in OHS. OHS caregivers may not be uniformly aware of recommendations for back sleeping. This study evaluates changes in the proportion of SIDS deaths occurring in OHS, before and after 1994 implementation of the back to sleep campaign. Methods: California’s Sudden Unexplained Infant Death Surveillance System data were used to evaluate these changes between 1992 and 1996. Data are extracted from vital records, death scene investigations and autopsy reports mandated for all unexplained infant deaths in California. SIDS deaths were identified by ICD-9 code 798.0. OHS deaths were those in which the infant was found somewhere other than the natural, adoptive or foster parents’ home. Results: 2,373 SIDS deaths were reported in 1992-1996. Of these, 1,988 with complete data for location found, have been included in this analysis. 19.9 % of the deaths occurred in OHS. The proportion of all OHS SIDS deaths increased significantly from 15.9% in 1992-1993 to 24.1% in 1994-1996 (p<0.05). Infants found dead in OHS were more likely to be white and to have older, more educated parents (p<0.05). Conclusions: Although SIDS rates have declined, the proportion of SIDS deaths occurring in OHS has increased. Recommendations for back sleeping, associated with declines in SIDS rates statewide, may not be effectively reaching infant caregivers. Implications: Educational campaigns are needed to ensure that back sleeping is routinely promoted in all infant care settings.

Learning Objectives: At the conclusion of this session, the participants in this session will be able to: 1. Describe changes in California’s SIDS mortality between 1992 and 1996. 2. Describe changes in the proportion of SIDS deaths occurring in parental homes vs. other settings from 1992 through 1996 in California. 3. Recognize the need for public health strategies to ensure that back sleeping is routinely promoted in all infant care settings

Keywords: SIDS, Child Care

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.

The 128th Annual Meeting of APHA