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Am J Epidemiol. 2006 Apr 15;163(8):762-9.

Recent national trends in sudden, unexpected infant deaths: more evidence supporting a change in classification or reporting.

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Maternal and Infant Health Branch, Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA 30341-3717, USA.


The recent US decline in sudden infant death syndrome (SIDS) rates may be explained by a shift in how these deaths are classified or reported. To examine this hypothesis, the authors compared cause-specific mortality rates for SIDS, other sudden, unexpected infant deaths, and cause unknown/unspecified, and they evaluated trends in the age and month of death for these causes using 1989-2001 US linked birth/death certificate data. Reported deaths in state and national data were compared to assess underreporting or overreporting. SIDS rates declined significantly from 1989-1991 to 1995-1998, while deaths reported as cause unknown/unspecified and other sudden, unexpected infant deaths, such as accidental suffocation and strangulation in bed (ASSB), remained stable. From 1999-2001, the decline in SIDS rates was offset by increasing rates of cause unknown/unspecified and ASSB. Changes in the cause-specific age at death and month of death distributions suggest that cases once reported as SIDS are now being reported as ASSB and cause unknown/unspecified. Most of the decline in SIDS rates since 1999 is likely due to increased reporting of cause unknown/unspecified and ASSB. Standardizing data collection at death scenes and improving the reporting of cause of death on death certificates should improve national vital records data and enhance prevention efforts.

[Indexed for MEDLINE]

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