The 130th Annual Meeting of APHA

4048.0: Tuesday, November 12, 2002 - 9:15 AM

Abstract #50160

Detection of infant deaths from overlay asphyxia and a resulting prevention initiative on safe sleeping practices for infants

Jacquelyn M. Caglia, BA student, Boston University, 827 Noble Street, Norristown, PA 19401, 617-356-5565 or 610-272-0629, jacquec14@hotmail.com and Laurel A. Spielberg, MPH, DrPH, School of Public Health, MCP Hahnemann University, 245 N. 15th Street, Mail Stop 660, Philadelphia, PA 19102-1192.

The Montgomery County (Pennsylvania) Child Death Review Team reviewed the deaths of all fourteen infants who died sudden deaths over the period 1996-1999. These deaths had been variably classified on death certificates as SIDS (n=10), Sudden Unexplained Infant Death (n=3), or overlay asphyxiation (n=1). Based on retrospective review that considered linked birth and death certificates, autopsy evidence, parental/witness information in CoronersŐ reports, police and death scene investigation reports, the Team determined that 4 deaths (28.6%) were actually caused by asphyxia due to overlay by an adult. Comparison of overlay deaths to SIDS deaths in our population revealed that both sexes were equally represented in both cause of death groups; non-Caucasian infants were over-represented among SIDS deaths. Overlay deaths occurred among significantly younger infants (mean age 28 days; range 14-30 days) than did SIDS (mean age 77 days; range 3-180 days). Each case of overlay asphyxia involved an infant sharing a sleeping surface other than a crib with at least one adult. Parental alcohol use was evident in half of overlay deaths. A resulting prevention initiative is now underway in our county, focusing on safe sleeping practices for infants. Parents and caregivers are targeted through a culturally and literacy sensitive information pamphlet. A slide/lecture education package on SIDS, sleep practices and bedsharing reaches nurses, health educators, and community workers. The Child Death Review process alerts us that overlay is a preventable cause of infant death. It may go undetected without detailed death review, and is most often misclassified as SIDS.

Learning Objectives: At the completion of this session participants will be able to

Keywords: Infant Mortality, SIDS

Presenting author's disclosure statement:
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.

Emerging Issues in Infant and Perinatal Mortality in the United States

The 130th Annual Meeting of APHA