Exploring contextual risks for infant sleep-related injury deaths in New York city, 2004-2010
Methods: Retrospective review of 122 death-scene investigations in NYC from 2004-2010 infants <1 year of age with the ICD-10 codes encompassing asphyxia and undetermined injuries where a crib or bassinet was identified. Analysis of autopsy reports, police reports, and medico-legal investigator notes identified factors that may have contributed to the crib or bassinet not being used.
Results: Known risk factors for infant asphyxia and suffocation were identified; 74% of infants (n=344) were found on an unsafe sleep surface, including adult beds, couches and car seats (n=255). In 48% of these cases (n=122), a crib or bassinet was in the home. Qualitative findings identified environmental threats (e.g., lack of space, vermin infestation, room temperature), and families' knowledge and behavior about suffocation deaths (e.g., parents' fear of cribs as a cause of crib death) as reasons why the crib was not being used.
Conclusion: Infants are at risk of death from sleep related infant injuries even when a crib or bassinet is present. Understanding the environmental factors and living conditions that may contribute to infants sleeping on an unsafe surface or bed sharing can help maternal child health professionals develop more appropriate interventions.
Learning Areas:Administer health education strategies, interventions and programs
Assessment of individual and community needs for health education
Planning of health education strategies, interventions, and programs
Public health or related nursing
Social and behavioral sciences
Identify environmental risk factors that may contribute to sleep-related infant injury deaths.
Keyword(s): Injury Risk, Infant Mortality
Qualified on the content I am responsible for because: I was a deputy director at the NYC Department of Health and coordinated research of infant mortality for four years. In 2007 I created and managed the NYC Cribs for Kids safe sleep and crib distribution program and I co-authored a report on the epidemiology of infant sleep related injuries in NYC.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.