Unexpected sudden deaths of black infants surge in 2020

CNN
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Thousands of babies die suddenly and unexpectedly every year, and more than 3,300 young lives were lost in 2020. Mortality remained high in the first year of the Covid-19 pandemic, even as overall infant mortality fell to record lows.

the study A paper published Monday in the journal Pediatrics found that the proportion of black babies in particular has skyrocketed, widening an already dire inequality.

Approximately 1 in 6 infant deaths was considered sudden infant death (SUID). SUID is a broad classification of death that includes sudden infant death syndrome known as SIDS, accidental suffocation or strangulation in bed, and other unknown causes.

While SUID rates for white babies have fallen to their lowest since 2017, rates for black babies in 2020 were the highest since then. Already nearly twice as high in 2017, the proportion of black babies has nearly tripled in 2020, the study found.

Sharyn Parks Brown, an epidemiologist in the Division of Reproductive Health at the US Centers for Disease Control and Prevention and co-author of the study, repeated the data several times to ensure that the research team was interpreting the findings correctly. said to have analyzed.

For decades, SUID rates have been consistent within each racial and ethnic group, and were always highest among American Indian infants. exceeded the percentage.

“We typically look at five years of data, ideally, to see if any trends are emerging. So these are very preliminary findings,” Parks Brown said. says. “But this is something we must continue to monitor.”

In a commentary on the study, the doctors say the sudden and unanticipated high infant mortality rates and rising inequalities in the United States “reflect our social failures.”

Socioeconomic disparities “not only limit access to health care and education, but also result in many families not having a stable and safe place for their infants to sleep,” they write.

In 2020, 41% of sudden infant deaths were attributed specifically to SIDS, 27% were identified as accidental suffocation and strangulation in bed, and 31% were classified as unknown causes.

Deaths attributed to SIDS in particular surged between 2019 and 2020, rising from the fourth leading cause of infant mortality to the third.

But this particular trend could highlight how little we know about these deaths, new research suggests.

The lines between the three classifications within the SUID category are blurry and the proportions have changed over the years. Experts say there is so much variation in how coroners and coroners code the code that it’s as indistinguishable as it looks.

“The distinction between the underlying cause of SIDS and an unknown cause of death is not well defined, in a new study.

Those responsible for death diagnosis have convened several important conferences in recent years with the specific intention of finding consistency in practice. Her unexpected increase in SIDS deaths in 2020 is most likely the result of changes in diagnostic criteria, according to a new study.

While SIDS rates increased by about 15% from 2019 to 2020, the broader SUID rate (which also includes deaths from accidental asphyxiation and other unknown causes) increased by only 3% that year. Researchers found an increase that was not considered statistically significant. .

Yet the latest data highlight why it is important to continue to focus on and better understand this topic.

“In some ways it was encouraging that the SUID rate did not increase,” said Parks Brown.

“But it only further underscores what we have seen over the last few decades. We have not been successful in reducing these deaths.”

It is also important to elucidate the specific causes behind sudden, unexpected infant deaths.

“The bottom line is that you can’t prevent something if you don’t know what caused it,” she said. This includes conducting a thorough autopsy and conducting a very detailed death scene investigation to determine what happened to the infant.”

Despite attempts to better differentiate within the broader category of sudden unexpected death in infants, experts say there is an important underlying thread.

“Almost all SUID deaths have at least one unsafe sleep risk factor. More than 95% of them,” says Rebecca Carlin, M.D., a pediatrician at Columbia University’s Vagelos College of Physicians and Surgeons. .

This includes the infant sleeping on its back, sleeping in the parent’s bed instead of the crib, soft bedding or pillows in the crib, or parental tobacco use.

These unsafe sleep habits are a risk factor because they reduce how easy it is for infants to wake up, usually every few hours when they need to, said a co-author of a commentary released Monday alongside the study. Carlin, who was

“In most cases, there is one risk factor that can actually be averted with additional social support, often multiple,” she said.

“Being a new parent is hard, and it’s hard to talk about these issues without talking about the support we, as a society, give to new parents.

Returning to work within six weeks of the child’s birth and still waking up with him every three hours was not realistic, she said. I can understand why you rely on me.

“Funding to adequately assess and support the changes needed to address the root causes of adverse health effects and inequitable social conditions and systems that disproportionately affect Black and Indigenous communities. is essential and focuses on community-led efforts that may increase protective factors and reduce risks,” said Sabra. Anckner, deputy director of clinical and community collaboration at the Association for Maternal and Child Health Programs, was not involved in this new study.

Many socioeconomic factors that disproportionately put black babies and their families at risk for worsening overall health have only worsened during the pandemic, according to experts. Factors may have permeated and influenced safe sleep habits.

Judy Bannon, CEO and Founder of Cribs for Kids, said: Cribs for Kids, a national group that provides cribs to those in need and advocates for safe sleep practices for infants, was not involved in the new research.

Experts agree that continuing education and community support to strengthen safe sleep practices are important, and that time spent in the postpartum hospital is an important opportunity.

Among other programs, Cribs for Kids has a hospital accreditation program that recognizes hundreds of hospitals nationwide for their commitment to safe sleep practices.

We also have a public safety initiative, working with law enforcement’s local EMS to monitor where babies sleep when they’re home for whatever reason.

“It’s a matter of parents hearing about it wherever you go,” Bannon said.