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1.
Aust N Z J Public Health ; 43(6): 570-576, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31667984

RESUMO

OBJECTIVE: To investigate the under-identification of Indigenous∗ infants in death records and examine the impact of a multi-stage algorithm on disparities in sudden unexpected deaths in infancy (SUDI). METHODS: Data on SUDI in Queensland between 2010 and 2014 were linked to birth and death registrations, health data, and child protection and coronial records. An algorithm was applied to cases of SUDI and population data to derive Indigenous status. Numbers, proportions and rates of SUDI were compared. RESULTS: Using multiple sources of Indigenous status resulted in a 64.9% increase in the number of infants identified as Indigenous. The Indigenous SUDI rate increased by 54.3%, from 1.38 to 2.13 per 1,000 live births after applying the algorithm to SUDI and live births data. CONCLUSIONS: Applying an algorithm to both numerator and denominator data reduced numerator-denominator incompatibility, to more accurately report rates of Indigenous SUDI and measure the gap in Indigenous infant mortality. Implications for public health: Estimation of the true magnitude of the disparity is restricted by under-identification of Indigenous status in death records. Data linkage improved the reporting of Indigenous infant mortality. Accuracy in reporting of measures is integral to determining genuine progress towards Closing the Gap.


Assuntos
Mortalidade Infantil/etnologia , Grupo com Ancestrais Oceânicos , Morte Súbita do Lactente/etnologia , Algoritmos , Causas de Morte , Atestado de Óbito , Documentação/normas , Feminino , Humanos , Lactente , Recém-Nascido , Armazenamento e Recuperação da Informação , Masculino , Queensland/epidemiologia , Fatores de Risco , Morte Súbita do Lactente/epidemiologia
2.
Ital J Pediatr ; 45(1): 95, 2019 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-31375123

RESUMO

BACKGROUND: Sudden unexpected postnatal collapse of presumably healthy neonates during early skin-to-skin contact is a rare, yet recognized occurrence, associated with a high risk of mortality and morbidity. A survey was conducted in 2012 in 30 delivery wards throughout Piedmont and the Aosta Valley to evaluate the environmental and logistical aspects that could be linked to SUPC. The survey was again conducted in 2016 in 28 delivery wards in Piedmont and the Aosta Valley in order to evaluate organizational improvements introduced after ministerial indications and recommendations by the Italian Society of Neonatology were published in 2014, in light of new findings regarding the phenomenon. METHODS: A questionnaire specifically asking about the organization of delivery wards, and surveillance or supervision during early skin-to-skin contact, was sent to all of the hospitals taking part in the survey in both 2012 and 2016. The collected data were elaborated anonymously and the statistical analysis was performed by using the two by two table. RESULTS: In 2012, 28 out of 30 delivery wards in Piedmont and Aosta, with a total of 31,074 newborns out of 35,435, were evaluated in all of the environmental and logistical aspects that might be cause for SUPC to occur. An identical survey was taken again in 2016; 26 out of 28 wards participated with a total of 27,484 newborns out of 30,339. In 2012, early skin-to-skin contact took place immediately in all the delivery rooms in 27 wards, and soon after in the post-partum room in one; in 11 out of 28 wards there was early skin-to-skin contact in the operating theater itself, following caesarean sections (11/26 in 2016). Routine newborn care was given after 3 h in 8 delivery wards (7/26 in 2016); after 2 h in 12 (7/26 in 2016); after 1 h in 2 (4/26 in 2016); after 30 min in 3 (2/26 in 2016); after 10 min in 1 (0/26 in 2016); after 1 or 2 min in 1 (0/26 in 2016) and at any time in one ward (6/26 in 2016). CONCLUSION: Periodic surveys of delivery wards are useful for the assessment of all the aspects and risk factors that need to be changed in order to implement safe early skin-to-skin contact.


Assuntos
Salas de Parto/organização & administração , Método Canguru , Morte Súbita do Lactente/prevenção & controle , Feminino , Humanos , Recém-Nascido , Itália/epidemiologia , Estudos Longitudinais , Gravidez , Morte Súbita do Lactente/epidemiologia , Inquéritos e Questionários
3.
Am J Forensic Med Pathol ; 40(3): 232-237, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31205057

RESUMO

Sudden infant deaths might be attributable to adverse reaction to vaccination, but separating them from coincidental occurrences is difficult. This study retrospectively investigated vaccination-related details and postmortem findings for 57 cases of sudden death in children 2 years or younger. Data were extracted from autopsy files at the Department of Forensic Medicine, Tokai University School of Medicine. Vaccination histories were available in 50 cases based on the maternity passbook. Of the 32 cases in which any vaccines were administered, 7 infants (21.9%) had received immunization within 7 days of death. The most frequent vaccine cited as the last immunization before death was Haemophilus influenzae B. Although a temporal association of vaccines with sudden death was present for two 3-month-old and one 14-month-old infants in whom death occurred within 3 days of receiving the H. influenzae type b and other vaccinations, a definitive relationship between the vaccine and death could not be identified. Histopathological examinations revealed pneumonia and upper respiratory infection as contributing to death in their cases. Moreover, all 3 cases showed hemophagocytosis in the spleen and lymph nodes, which are similar features to hemophagocytic lymphohistiocytosis. Judgment of the disorders as truly related to vaccination is difficult, but suspicious cases do exist. Forensic pathologists must devote more attention to vaccination in sudden infant death cases.


Assuntos
Morte Súbita do Lactente/epidemiologia , Vacinação/efeitos adversos , Encefalopatias/mortalidade , Enterite/mortalidade , Feminino , Patologia Legal , Cardiopatias Congênitas/mortalidade , Humanos , Íleus/mortalidade , Lactente , Recém-Nascido , Vírus da Influenza A/isolamento & purificação , Japão/epidemiologia , Linfonodos/patologia , Masculino , Fagocitose , Pneumonia/mortalidade , Infecções Respiratórias/mortalidade , Estudos Retrospectivos , Baço/patologia , Streptococcus/isolamento & purificação
4.
Intern Med J ; 49(4): 433-438, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30957377

RESUMO

Despite significant reductions in incidence since the introduction of safe infant sleeping recommendations, sudden infant death syndrome is still the major cause of neonatal death in western countries. In the United States, over 2500 infants die suddenly and unexpectedly each year with nearly 100 deaths annually in Australia. Health professionals play a critical role in advising parents how to sleep their infants safely to minimise the risk of sudden infant death syndrome and sleeping accidents. Infants should be placed supine to sleep in a cot with a firm well-fitting mattress in the parental bedroom with no soft or loose bedding which could obstruct the airway. Exposure to smoking both before and after birth should be minimised. Breastfeeding should be encouraged, as should immunisation. Dummies can be recommended after breastfeeding has been established. This review outlines the evidence behind these recommendations.


Assuntos
Aleitamento Materno , Causas de Morte , Morte Súbita do Lactente/epidemiologia , Morte Súbita do Lactente/prevenção & controle , Austrália/epidemiologia , Roupas de Cama, Mesa e Banho/efeitos adversos , Meio Ambiente , Feminino , Humanos , Lactente , Recém-Nascido , Recém-Nascido Prematuro , Decoração de Interiores e Mobiliário , Gravidez , Decúbito Ventral , Medição de Risco , Fatores de Risco , Fumar/efeitos adversos , Estados Unidos/epidemiologia
5.
Pediatrics ; 143(5)2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31010907

RESUMO

BACKGROUND: Unintentional suffocation is the leading cause of injury death among infants <1 year old in the United States, with 82% being attributable to accidental suffocation and strangulation in bed. Understanding the circumstances surrounding these deaths may inform prevention strategies. METHODS: We analyzed data from the population-based Sudden Unexpected Infant Death Case Registry from 2011 to 2014. Cases categorized as explained suffocation with unsafe sleep factors (suffocation), per the Centers for Disease Control and Prevention's Sudden Unexpected Infant Death Case Registry classification system, were included and assigned a mechanism of obstruction, including soft bedding, overlay, or wedging. We calculated frequencies and percentages of suffocation deaths by mechanism and selected demographic and sleep-environment characteristics. RESULTS: Fourteen percent of sudden unexpected infant death cases were classified as suffocation; these cases were most frequently attributed to soft bedding (69%), followed by overlay (19%) and wedging (12%). Median age at death in months varied by mechanism: 3 for soft bedding, 2 for overlay, and 6 for wedging. Soft-bedding deaths occurred most often in an adult bed (49%), in a prone position (82%), and with a blanket (or blankets) obstructing the airway (34%). Overlay deaths occurred most often in an adult bed (71%), and infants were overlaid by the mother (47%). Wedging deaths occurred most often when the infant became entrapped between a mattress and a wall (48%). CONCLUSIONS: Safe sleep environments can reduce infant suffocation deaths. Increased knowledge about the characteristics of suffocation deaths can help inform prevention strategies by targeting highest-risk groups.


Assuntos
Asfixia/epidemiologia , Roupas de Cama, Mesa e Banho/efeitos adversos , Equipamentos para Lactente/efeitos adversos , Sono , Morte Súbita do Lactente/epidemiologia , Asfixia/prevenção & controle , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Decúbito Ventral/fisiologia , Sistema de Registros , Fatores de Risco , Sono/fisiologia , Morte Súbita do Lactente/prevenção & controle
6.
Ital J Pediatr ; 45(1): 28, 2019 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-30819214

RESUMO

BACKGROUND: Although several modifiable risk factors have been identified, and prone and side sleep positions were identified as preventing sudden infant death syndrome (SIDS), the epidemiology of sudden unexpected deaths in infancy (SUDI), which includes SIDS, has not unchanged in over a decade. What can be done? METHODS: Italian infant mortality rates were analysed between 1996 and 2015. RESULTS: Between 1996 and 2015 in Italy 1152 SUDI deaths were reported in infants less than one year old. SUDI decreased substantially from 18 in 1996 to 10.2 deaths per hundred live births in 2015 (- 43%), the contribution was the change in the SIDS rate from 11.3 to 4.1 (- 64%). However, since 1004 main and SIDS rates have not changed. CONCLUSION: Interventions that support safe sleep must be maintained, but research is still needed since although these dramatic deaths have been reduced their causes remain unknown. The challenge is now to shift their trend which has been constant for too long.


Assuntos
Morte Súbita do Lactente/epidemiologia , Morte Súbita do Lactente/prevenção & controle , Feminino , Humanos , Lactente , Mortalidade Infantil , Recém-Nascido , Itália/epidemiologia , Masculino , Fatores de Risco , Síndrome
7.
Pediatrics ; 143(4)2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30858347

RESUMO

OBJECTIVES: Maternal smoking during pregnancy is an established risk factor for sudden unexpected infant death (SUID). Here, we aim to investigate the effects of maternal prepregnancy smoking, reduction during pregnancy, and smoking during pregnancy on SUID rates. METHODS: We analyzed the Centers for Disease Control and Prevention Birth Cohort Linked Birth/Infant Death Data Set (2007-2011: 20 685 463 births and 19 127 SUIDs). SUID was defined as deaths at <1 year of age with International Classification of Diseases, 10th Revision codes R95 (sudden infant death syndrome), R99 (ill-defined or unknown cause), or W75 (accidental suffocation or strangulation in bed). RESULTS: SUID risk more than doubled (adjusted odds ratio [aOR] = 2.44; 95% confidence interval [CI] 2.31-2.57) with any maternal smoking during pregnancy and increased twofold between no smoking and smoking 1 cigarette daily throughout pregnancy. For 1 to 20 cigarettes per day, the probability of SUID increased linearly, with each additional cigarette smoked per day increasing the odds by 0.07 from 1 to 20 cigarettes; beyond 20 cigarettes, the relationship plateaued. Mothers who quit or reduced their smoking decreased their odds compared with those who continued smoking (reduced: aOR = 0.88, 95% CI 0.79-0.98; quit: aOR = 0.77, 95% CI 0.67-0.87). If we assume causality, 22% of SUIDs in the United States can be directly attributed to maternal smoking during pregnancy. CONCLUSIONS: These data support the need for smoking cessation before pregnancy. If no women smoked in pregnancy, SUID rates in the United States could be reduced substantially.


Assuntos
Resultado da Gravidez , Abandono do Hábito de Fumar/métodos , Fumar/efeitos adversos , Fumar/epidemiologia , Morte Súbita do Lactente/epidemiologia , Morte Súbita do Lactente/etiologia , Intervalos de Confiança , Bases de Dados Factuais , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Comportamento Materno , Determinação de Necessidades de Cuidados de Saúde , Razão de Chances , Gravidez , Estudos Retrospectivos , Medição de Risco , Autorrelato , Estados Unidos
8.
J Forensic Leg Med ; 62: 52-55, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30658266

RESUMO

OBJECTIVE: Sudden Unexpected Infant Deaths (SUID) is defined as a combination of Sudden Infant Death Syndrome (SIDS), Unknown Cause of Death (UCD) and Accidental Suffocation and Strangulation in Bed (ASSB). Overall rates from 2000 to 2015 have been trending down. Racial differences in occurrence are seen. STUDY DESIGN AND SETTING: Using the CDC Wonder Database, the total rates of SUID and its subsets were examined. RESULTS: Non-Caucasian infant death rates for the total SUID group, and the SIDS component, are trending downward significantly faster than for Caucasians. UCD trends in rates show an apparent small, non-significant, decline for non-Caucasians, and are unchanged for Caucasians. ASSB rates are trending upward slightly more rapidly (not significantly) for non-Caucasians than Caucasians. CONCLUSION: The trend showing ASSB trending upward more in non-Caucasians than Caucasians may suggest: 1) A racial difference that certifiers are more willing to certify SIDS than ASSB in Caucasians, and/or 2) Certifiers are biased towards certifying more ASSB than SIDS in non-Caucasians, and/or 3) Asphyxia risks may be increasing more in non-Caucasian SUIDs. Option #1 would require educational efforts to recognize the asphyxia risks in Caucasians. Option #2 would require documentation of racial bias in infant death certification followed by efforts to reduce the bias. Option #3 would require focused targeting of non-Caucasian populations to reduce asphyxia risks. Potentially all three scenarios could co-exist.


Assuntos
Asfixia/mortalidade , Grupos de Populações Continentais/estatística & dados numéricos , Morte Súbita do Lactente/epidemiologia , Acidentes Domésticos/mortalidade , Roupas de Cama, Mesa e Banho , Bases de Dados Factuais , Humanos , Lactente , Mortalidade Infantil , Estados Unidos/epidemiologia
9.
J Forensic Leg Med ; 62: 7-13, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30612007

RESUMO

In China, every year many infants (<1 year) are abandoned, but abandonment related deaths are rarely reported. In this study, the police records of infant deaths in Pudong, Shanghai have been explored, then, the police data were compared with the corresponding Centre for Disease Control ("CDC") data. During the period 2004-2017, a total of 297 infant deaths were recorded by the police, including 87 sudden natural deaths (occurred outside hospitals) and 210 unnatural deaths. The CDC data were retrieved from a Chinese article. Joinpoint Trend Analysis was used to evaluate the trend of the police records on infant deaths, and Poisson regression was used to calculate the mortality rate ratio ("RR") by gender and places of origin (local, migrant, unknown identity). It is observed that infants born to migrant mothers were more vulnerable to sudden natural deaths than their local counterparts (RR: 4.6, 95% CI: 2.8 to 8.1). 8 abandonment deaths and 187 suspicious abandonment deaths were spotted. Births to unmarried mothers, severe illnesses, and deformities could be important risk factors resulting in abandonments. However, the female gender was not a reason that led to the abandonments. Infant deaths related to abandonments/suspicious abandonments rapidly declined during the period 2004-2017. The CDC data showed that 27 infants died of unnatural causes during the period 2002-2013, while the police data recorded 182 unnatural infant deaths during the period 2004-2013, a shorter period but more unnatural deaths. Thus, the CDC data could have underreported the infant deaths.


Assuntos
Acidentes/mortalidade , Criança Abandonada/estatística & dados numéricos , Homicídio/estatística & dados numéricos , Mortalidade Infantil , Morte Súbita do Lactente/epidemiologia , China/epidemiologia , Feminino , Órgãos Governamentais , Humanos , Lactente , Masculino , Mães/estatística & dados numéricos , Polícia , Estudos Retrospectivos , Migrantes/estatística & dados numéricos
10.
Compr Child Adolesc Nurs ; 42(2): 151-160, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29617167

RESUMO

Sudden unexplained death in infancy, including sudden infant death syndrome (SIDS), is a global public health challenge. Despite public health campaigns and efforts, SIDS remains the leading cause of postneonatal mortality in many developed countries. In this article, we review SIDS, describe nursing's unique professional position in addressing this problem, and explore how the principles of social justice can inform nursing's response. Motivated by nursing's ethical and moral obligations, the profession is called to take an active role in educating others regarding this phenomenon, to participate in research, and to develop or advocate for policy that aims to reduce the incidence of SIDS on an international scale.


Assuntos
Saúde Global/normas , Mortalidade Infantil , Cuidados de Enfermagem/normas , Morte Súbita do Lactente/epidemiologia , Saúde Global/tendências , Disparidades em Assistência à Saúde , Humanos , Lactente , Recém-Nascido , Cuidados de Enfermagem/métodos
11.
Arch Dis Child ; 104(1): 30-36, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-29802134

RESUMO

OBJECTIVE: To develop a detailed understanding of the circumstances of sudden unexpected death in infancy (SUDI) cases subject to serious case review (SCR). DESIGN: This was a thematic analysis of SCRs relating to cases of SUDI in England. SCRs were obtained for SUDI cases dying between 1 April 2011 and 31 March 2014. These were cases (aged 0-2 years) that presented as a SUDI and for which no clear medical or forensic cause of death was found. RESULTS: SCRs were held for 30 SUDI cases, published reports were available for 27/30. The median (range) age at death was 2 (0-19) months. Background risk factors in families included: alcohol or drug dependency in 18/27, parental mental health problems in 14/27, domestic abuse in 9/27 and parental criminal records in 13/27. Nineteen infants had received support from social care, 10/19 were subject to child protection plans. Neglect was a feature in 15/27 cases. Parents did not engage with professionals in 18/27 cases, involving social care in 14/18, health care in 13/18 and drug and substance misuse services in 5/18. Eighteen of 27 deaths occurred in highly hazardous sleep environments, 16/18 involved cosleeping and 13/16 cosleeping deaths occurred with parents who were intoxicated with alcohol or impaired by drugs. CONCLUSION: Most SUDI cases occurred in hazardous sleep environments and are potentially preventable. They occurred in families well known to services with concerns about neglect, substance misuse and poor engagement. More consideration is needed on how best to support such vulnerable families.


Assuntos
Causas de Morte , Cuidado do Lactente , Anamnese/estatística & dados numéricos , Sono , Morte Súbita do Lactente , Violência Doméstica/legislação & jurisprudência , Violência Doméstica/estatística & dados numéricos , Meio Ambiente , Feminino , Humanos , Lactente , Cuidado do Lactente/normas , Cuidado do Lactente/estatística & dados numéricos , Recém-Nascido , Masculino , Determinação de Necessidades de Cuidados de Saúde , Pais/psicologia , Fatores de Risco , Serviço Social/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Morte Súbita do Lactente/epidemiologia , Morte Súbita do Lactente/etiologia , Morte Súbita do Lactente/patologia , Morte Súbita do Lactente/prevenção & controle , Reino Unido/epidemiologia
12.
Matern Child Health J ; 23(2): 183-190, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30105515

RESUMO

Objective to evaluate women's knowledge about the best baby sleeping position and to identify factors associated with a greater probability of putting infants to sleep in an unsafe position, in Rio Grande, Southern Brazil. Method This is a cross-sectional population-based study that included all women who bore children in 2013 in this municipality. A single, standardized questionnaire was given within 48 h after delivery in the only two local maternity hospitals. The outcome was that women reported the lateral and the ventral decubitus as the best sleeping positions for babies. A Chi square test was used for proportions and Poisson regression was used with robust variance adjustment in the multivariate analysis. The prevalence ratio was the measure of effect used. Results We included 2624 women in this study. Of these, 82.1% (95% CI 80.6-83.6) stated that the baby should sleep in the lateral or ventral decubitus positions. 76.4% reported having acquired this knowledge from their mothers and 34.7% were willing to adopt the correct (supine) sleeping position for their child if recommended by doctors. The adjusted analysis showed that the lower the schooling of the mothers and the greater the number of people per bedroom and number of children, the greater the probability of women choosing an unsafe baby sleeping position. Conclusions for Practice This study showed that the percentage of women who are unaware of the correct baby sleeping position is very high, that doctors should be convinced to recommend the supine baby sleeping position, and that campaigns on this subject should also include grandparents as a priority intervention group.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Cuidado do Lactente/normas , Mães/psicologia , Posicionamento do Paciente/normas , Adolescente , Adulto , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Lactente , Cuidado do Lactente/métodos , Recém-Nascido , Mães/educação , Análise Multivariada , Posicionamento do Paciente/métodos , Morte Súbita do Lactente/epidemiologia , Morte Súbita do Lactente/prevenção & controle , Inquéritos e Questionários
13.
Paediatr Int Child Health ; 39(2): 104-110, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30382004

RESUMO

Background: Although the incidence of sudden unexpected infant death (SUID) has decreased since the 'Back to Sleep' campaign in English-speaking countries and other preventive campaigns, the circumstances of such deaths remain unclear. Aim: To analyse infant deaths recorded at the referral centre for sudden infant death of the West Provence-Alpes-Côte d'Azur region of France (West PACA) and the forensic medicine department of Marseille University Hospital. Methods: Information on all SUID cases from 2000 to 2017 was extracted from the referral centre for sudden infant deaths in West PACA and the forensic medicine department of Marseille. Results: The study included 130 infants over the 17 years with a very similar distribution. There was a marked male preponderance, with 61.6% of boys whatever the age at death (sex ratio 1.6). Half of the deaths occurred in the first 6 months of life and the majority (61%) of infants died during autumn and winter. Nearly one-third (33.2%) had presented with minor infections and 21% had been seen by a doctor or had been admitted to hospital. Most deaths (86.4%) occurred during sleep (night or day). Nearly half of the infants (47.7%) were discovered in a prone position. A large majority of parents (90.7%) agreed to a post-mortem examination. Only 6.2% of deaths led to legal proceedings. Nearly 16.9% remained unexplained after compiling all the data included in the protocol and 9.2% remained unexplained because of incomplete investigation, including refusal of post-mortem examination. Abuse was involved in 2.3% of cases. Conclusions: Asymptomatic infectious conditions were associated with a high proportion of SUID cases. Non-supine sleep positions were still practised. There is a need to increase SUID prevention campaigns. Abbreviations: HAS, Haute Autorité de Santé: French National Health Authority; NICHD, National Institute of Child Health and Human Development; PACA, Provence-Alpes-Côte d'Azur region of France; SUID, sudden unexpected infant death; SIDS, sudden infant death syndrome; CépiDc, Centre d'Epidémiologie sur les Causes Médicales de Décès/Center for Epidemiology on the Medical Causes of Death.


Assuntos
Morte Súbita do Lactente/epidemiologia , Morte Súbita do Lactente/etiologia , Fatores Etários , Feminino , França/epidemiologia , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Estudos Retrospectivos , Fatores Sexuais
14.
NCHS Data Brief ; (326): 1-8, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30475688

RESUMO

Infant mortality is an important public health measure in the United States and other countries (1-3). The United States' infant mortality rate started to decline in 2007 (the most recent high), but has remained relatively unchanged in recent years (4,5). Previous research shows differences in infant mortality rates by age at death (i.e., neonatal, or deaths to infants aged 0-27 days, and postneonatal, or deaths to infants aged 28-364 days), age and race and Hispanic origin of the mother, and leading causes of death (4-6). This report examines infant mortality rates for the United States by age at death in 2016, by maternal age and race and Hispanic origin, and for the five leading causes of neonatal and postneonatal mortality.


Assuntos
Grupos de Populações Continentais/estatística & dados numéricos , Mortalidade Infantil/tendências , Afro-Americanos , Causas de Morte , Anormalidades Congênitas/epidemiologia , Grupo com Ancestrais do Continente Europeu , Hispano-Americanos , Humanos , Índios Norte-Americanos , Lactente , Recém-Nascido de Baixo Peso , Recém-Nascido , Idade Materna , Mortalidade Perinatal/tendências , Morte Súbita do Lactente/epidemiologia , Estados Unidos/epidemiologia
15.
J Health Care Poor Underserved ; 29(4): 1188-1208, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30449742

RESUMO

The objectives of this study were to identify social determinants of health as risk factors for infant mortality, particularly among African Americans, and to determine the extent to which research has demonstrated an association between each social determinant of health and infant mortality. A systematic scoping review was conducted following PRISMA guidelines. Databases searched include: EBSCOhost, CINAHL Plus, PsycINFO, SocINDEX, Social Work Abstracts, and Sociological Collection. Following a three-step selection process conducted by two reviewers, 89 studies were included. The social ecological model was used to categorize both the search terms and the findings. Findings revealed that the majority of studies focused on the individual and public policy levels, and most failed to account for the complexity of the issue. Additional research is needed to explore the social determinants of health that are hypothesized to affect infant mortality across all levels, applying more complex, system-level approaches.


Assuntos
Afro-Americanos/estatística & dados numéricos , Mortalidade Infantil/etnologia , Determinantes Sociais da Saúde/etnologia , Aleitamento Materno/estatística & dados numéricos , Maus-Tratos Infantis/etnologia , Maus-Tratos Infantis/estatística & dados numéricos , Acesso aos Serviços de Saúde , Humanos , Lactente , Mortalidade Infantil/tendências , Saúde Materna/estatística & dados numéricos , Cuidado Pré-Natal/estatística & dados numéricos , Política Pública , Características de Residência , Fatores de Risco , Fumar/epidemiologia , Determinantes Sociais da Saúde/estatística & dados numéricos , Fatores Socioeconômicos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Morte Súbita do Lactente/epidemiologia
17.
JAAPA ; 31(11): 25-30, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30303830

RESUMO

Sudden infant death syndrome, a type of sleep-related sudden unexpected infant death (SUID) is the leading cause of postneonatal mortality in the United States and the third leading cause of infant death overall. Despite the evidence-based risk-reduction strategies and the highly publicized campaigns for a safe sleep environment, some infants continue to sleep in unsafe sleep conditions. Clinicians need to know the current best practices to reduce the incidence of sleep-related SUID and be knowledgeable to counsel caregivers who may resist adhering to these recommendations. This article describes the different types of SUID, associated risk factors, and highlights recommendations to help parents and caregivers ensure safe sleep environments for infants.


Assuntos
Educação em Saúde , Morte do Lactente/etiologia , Morte do Lactente/prevenção & controle , Sono , Morte Súbita do Lactente/etiologia , Morte Súbita do Lactente/prevenção & controle , Cuidadores , Aconselhamento , Meio Ambiente , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Pais , Fatores de Risco , Segurança , Morte Súbita do Lactente/epidemiologia , Decúbito Dorsal
18.
Epidemiol Prev ; 42(5-6): 301-307, 2018.
Artigo em Italiano | MEDLINE | ID: mdl-30370731

RESUMO

OBJECTIVES: to describe the prevalence of breastfeeding in Sicily Region (Southern Italy) and to analyze the socioeconomic status and other major risk factors on the attitudes towards exclusive breastfeeding. DESIGN: information on the practice of breastfeeding in Sicily have been collected from a Regional survey on Sudden Infant Death Syndrome (SIDS). An index of socioeconomic position was created by using data from the 2011 Census of the Italian National Institute of Statistics. SETTING AND PARTICIPANTS: in May 2015, a questionnaire was distributed to all mothers accessing to immunization services in Sicily for the first vaccination of their children. Two hundred seventy-three (273) vaccination centres have been involved, and 2,692 questionnaires were administered. MAIN OUTCOME MEASURES: five socio-economic levels were identified and, for each of them, the prevalence of breastfeeding and the risk factors for nonadherence to exclusive breastfeeding were described. RESULTS: the prevalence of exclusive breastfeeding was 30.6%, unevenly distributed in the region, being the lowest in the Province of Messina (21.4%). Nonadherence to exclusive breastfeeding was associated with the disadvantage of the low context culture (χ2: 14.9), and was more common in the areas with higher socioeconomic deprivation index (odds ratio - OR: 1.81). Among other determinants investigated, being premature was a risk factor for not being breastfed (OR: 1.59). CONCLUSION: the study confirms a low prevalence of breastfeeding in Sicily and its association with the socioeconomic level, being lower among women living in higher disadvantage areas. Moreover, this study confirms the association with co-sleeping practices (rooming-in and bed-sharing) for preterm babies. However, mother-child bed-sharing is not a guarantee for a successful breastfeeding, indeed being associated with a higher risk of SIDS. Finally, the study suggests the need for appropriate interventions focusing on specific high-risk groups.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Classe Social , Adulto , Feminino , Humanos , Recém-Nascido , Mães , Prevalência , Fatores de Risco , Sicília/epidemiologia , Fatores Socioeconômicos , Morte Súbita do Lactente/epidemiologia , Inquéritos e Questionários , Adulto Jovem
19.
J Pediatr ; 203: 423-428.e11, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30268395

RESUMO

OBJECTIVE: To determine whether a monogenic basis explains sudden infant death syndrome (SIDS) using an exome-wide focus. STUDY DESIGN: A cohort of 427 unrelated cases of SIDS (257 male; average age = 2.7 ± 1.9 months) underwent whole-exome sequencing. Exome-wide rare variant analyses were carried out with 278 SIDS cases of European ancestry (173 male; average age = 2.7 ± 1.98 months) and 973 ethnic-matched controls based on 6 genetic models. Ingenuity Pathway Analysis also was performed. The cohort was collected in collaboration with coroners, medical examiners, and pathologists by St George's University of London, United Kingdom, and Mayo Clinic, Rochester, Minnesota. Whole-exome sequencing was performed at the Genomic Laboratory, Kings College London, United Kingdom, or Mayo Clinic's Medical Genome Facility, Rochester, Minnesota. RESULTS: Although no exome-wide significant (P < 2.5 × 10-6) difference in burden of ultra-rare variants was detected for any gene, 405 genes had a greater prevalence (P < .05) of ultra-rare nonsynonymous variants among cases with 17 genes at P < .005. Some of these potentially overrepresented genes may represent biologically plausible novel candidate genes for a monogenic basis for a portion of patients with SIDS. The top canonical pathway identified was glucocorticoid biosynthesis (P = .01). CONCLUSIONS: The lack of exome-wide significant genetic associations indicates an extreme heterogeneity of etiologies underlying SIDS. Our approach to understanding the genetic mechanisms of SIDS has far reaching implications for the SIDS research community as a whole and may catalyze new evidence-based SIDS research across multiple disciplines. Perturbations in glucocorticoid biosynthesis may represent a novel SIDS-associated biological pathway for future SIDS investigative research.


Assuntos
Exoma , Predisposição Genética para Doença , Morte Súbita do Lactente/genética , Autopsia , Estudos de Casos e Controles , Criança , Pré-Escolar , Grupos Étnicos , Feminino , Variação Genética , Humanos , Lactente , Masculino , Minnesota , Mutação , Morte Súbita do Lactente/epidemiologia , Morte Súbita do Lactente/etnologia , Reino Unido
20.
J Epidemiol Community Health ; 72(10): 911-918, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-29973395

RESUMO

BACKGROUND: Unexplained deaths in infancy comprise 'sudden infant death syndrome' (SIDS) and deaths without ascertained cause. They are typically sleep-related, perhaps triggered by unsafe sleep environments. Preterm birth may increase risk, and varies with ethnicity. We aimed to compare ethnic-specific rates of unexplained infant death, explore sociodemographic explanations for ethnic variation, and examine the role of preterm birth. METHODS: We analysed routine data for 4.6 million live singleton births in England and Wales 2006-2012, including seven non-White ethnic groups ranging in size from 29 313 (Mixed Black-African-White) to 180 265 (Pakistani). We calculated rates, birth-year-adjusted ORs, and effects of further adjustments on the χ2 for ethnic variation. RESULTS: There were 1559 unexplained infant deaths. Crude rates per 1000 live singleton births were as follows: 0.1-0.2 for Indian, Bangladeshi, Pakistani, White Non-British, Black African; 0.4 for White British; 0.6-0.7 for Mixed Black-African-White, Mixed Black-Caribbean-White, Black Caribbean. Birth-year-adjusted ORs relative to White British ranged from 0.38 (95% CI 0.24 to 0.60) for Indian babies to 1.73 (1.21 to 2.47) for Black Caribbean (χ2(10 df)=113.6, p<0.0005). Combined adjustment for parents' marital/registration status and mother's country of birth (UK/non-UK) attenuated the ethnic variation. Adjustments for gestational age at birth, maternal age and area deprivation made little difference. CONCLUSION: Substantial ethnic disparity in risk of unexplained infant death exists in England and Wales. Apparently not attributable to preterm birth or area deprivation, this may reflect cultural differences in infant care. Further research into infant-care practices in low-risk ethnic groups might enable more effective prevention of such deaths in the general population.


Assuntos
Mortalidade Infantil/etnologia , Morte Súbita do Lactente/etnologia , Morte Súbita do Lactente/epidemiologia , Adulto , Causas de Morte , Bases de Dados Factuais , Inglaterra/epidemiologia , Grupos Étnicos , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Medição de Risco , País de Gales/epidemiologia , Adulto Jovem
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