Monday, 30 August 2010

SIDS: Decline In Sudden Infant Death Syndrome Contributed To Overall Decline In Infant Mortality In New Jersey

The rate of Sudden Infant Death Syndrome (SIDS), a leading cause of infant mortality, declined in New Jersey by 45 percent between 2000 and 2006, the most recent year for which final SIDS data are available, report Barbara M. Ostfeld, PhD, and Thomas Hegyi, MD, professors in the Department of Pediatrics at UMDNJ-Robert Wood Johnson Medical School and program director and medical director, respectively, for the Sudden Infant Death Syndrome (SIDS) Center of New Jersey. According to Dr. Hegyi, this decline has contributed to the 17 percent reduction in overall infant mortality in New Jersey between 2000 and 2007 that is described in 2010 KIDS COUNT, the newly issued report of the Annie E. Casey Foundation. The report also notes that the decline in New Jersey's overall infant mortality far exceeds the national trend of a 3 percent decline, placing New Jersey's rate fifth lowest among 50 states. According to Drs. Ostfeld and Hegyi, New Jersey's SIDS rate also falls below the national rate."In 2006, the rate for SIDS in New Jersey fell to 0.3 per thousand live births, the equivalent of three such deaths per 10,000 live births," said Dr. Ostfeld. "By contrast, in 2000, five infants in every 10,000 live births succumbed to SIDS, and a decade earlier, eight per 10,000 live births did so.""Preliminary data from the Center for Health Statistics of the New Jersey Department of Health and Senior Services suggests that the lower rate of SIDS deaths in 2006 was also observed in the period 2007 and 2008," explained Dr. Hegyi, who also serves as vice chair of the Department of Pediatrics.SIDS is defined as the sudden and unexpected death of an infant before the first birthday that remains unexplained even after a complete evaluation consisting of an autopsy, a death scene investigation and a review of the medical history. Many studies now suggest that one of the potential causes of such an unexplained death may turn out to be an abnormality in the brainstem that diminishes an infant's capacity to arouse and respond to breathing challenges such as those posed by sleeping prone (on the stomach) on soft bedding. Other risk factors for SIDS, such as exposure to tobacco smoke or overheating, can further compromise arousal."A comprehensive education program provided by healthcare professionals throughout the state that follows guidelines established by the American Academy of Pediatrics (AAP) has contributed to the improved outcomes for infant mortality in New Jersey," added Dr. Hegyi. "The decline in SIDS has been associated in great part with improved compliance with these recommendations by parents and other caregivers."Referring to the recent study in Pediatrics by Drs. Ostfeld and Hegyi that found that more than that 78 percent of SIDS cases contained multiple concurrent risk factors, Dr. Hegyi commented, "Risk-reduction education of new parents and all other caregivers, such as grandparents and babysitters, should be comprehensive. In addition to education about placing infants 'Back-to-Sleep,' the position associated with the lowest risk, all other recommendations of the AAP should also be described and discussed."The risk reduction education provided by the SIDS Center of New Jersey is all-inclusive, addressing all the risk factors and safe sleep guidelines described by the AAP including those related to prone sleep, sharing sleep surfaces with a sleeping adult, smoke exposure, presence of pillows, and other soft and loose bedding, and overheating. The SIDS Center of New Jersey promotes knowledge and compliance through the education of health and social service providers for infants and families, including providers in hospitals, child care centers, offices of the Division of Youth and Family Services, and health clinics, as well as with families directly."Until the biological causes for SIDS are fully defined and lead to the identification and treatment of living infants who may be vulnerable, the risk-reducing guidelines recommended by the American Academy of Pediatrics are considered by both researchers and healthcare providers to be the most effective interventions to date," says Dr. Ostfeld.

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