P KZN CDOP SUD

Classification of sleep‐related sudden unexpected death in infancy: A national survey

Joanna Garstang 

 

Aim

To identify how British Child Death Overview Panels (CDOPs) and paediatric pathologists classify cause of death for sleep‐related Sudden Unexpected Death in Infancy (SUDI). To determine compliance with national requirements for SUDI investigation.

Methods

Electronic survey of CDOPs and pathologists using three vignettes of SUDI cases illustrating: accidental asphyxia, typical Sudden Infant Death Syndrome (SIDS) and SIDS with co‐sleeping.

Results

Thirty‐eight (41%) of 92 CDOPs returned questionnaires, and 32 were complete. Thirteen (14%) of 90 pathologists returned complete questionnaires. Thirty‐one (97%) CDOPs and 7 (53%) pathologists agreed with the cause of death in the accidental asphyxia case; 24 (75%) CDOPs and 9 (69%) pathologists in the typical SIDS case; and 11 (34%) CDOPs and 1 (8%) pathologist in the co‐sleeping SIDS case. Pathologists used the terms SUDI or unascertained as the cause of death for the accidental asphyxia case (46%) and the co‐sleeping SIDS case (77%). These terms were used by CDOPs for the typical SIDS case (25%) and the co‐sleeping SIDS case (41%). Seventeen (46%) CDOPs reported compliance with guidelines for investigation in more than 75% of cases.

Conclusion

There is wide variation in classification of deaths, with only limited agreement between CDOPs and pathologists. The terms SIDS and accidental asphyxia are underused, even in typical cases.