Circumstances and factors of sleep-related sudden infancy deaths in Japan.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2020
Historique:
received: 30 04 2020
accepted: 06 08 2020
entrez: 22 8 2020
pubmed: 22 8 2020
medline: 2 10 2020
Statut: epublish

Résumé

Sudden unexpected death in infancy (SUDI) comprises both natural and unnatural causes of death. However, few epidemiological surveys have investigated SUDI in Japan. This retrospective study was conducted to investigate the latest trends of circumstances and risk factors of SUDI cases in which collapse occurred during sleep. Forensic pathology sections from eight universities participated in the selection of subjects from 2013 to 2018. Data obtained from the checklist form were analyzed based on information at postmortem. There were 259 SUDI cases consisting of 145 male infants and 114 female infants with a mean birth weight of 2888 ± 553 and 2750 ± 370 g, respectively. Deaths most frequently occurred among infants at 1 month of age (18%). According to population data as the control, the odds ratio (95% confidence interval) of mother's age ≤19 years was 11.1 (6.9-17.7) compared with ages 30-39. The odds ratio for the fourth- and later born infants was 5.2 (3.4-7.9) compared with the frequency of first-born infants. The most frequent time of day for discovery was between 7 and 8 o'clock, and the time difference from the last seen alive was a mean of 4.1 h. Co-sleeping was recorded for 61%, and the prone position was found for 40% of cases at discovery. Mother's smoking habit exhibited an odds ratio of 4.5 (2.9-5.8). This study confirmed the trends that have been observed for sudden infant death syndrome; particularly, very high odds ratios were evident for teenage mothers and later birth order in comparison with those in other developed countries. Neglect was suspected in some cases of the prolonged time to discovery of unreactive infants. To our knowledge, this is the first report of an extensive survey of SUDI during sleep in Japan.

Sections du résumé

BACKGROUND
Sudden unexpected death in infancy (SUDI) comprises both natural and unnatural causes of death. However, few epidemiological surveys have investigated SUDI in Japan.
OBJECTIVE
This retrospective study was conducted to investigate the latest trends of circumstances and risk factors of SUDI cases in which collapse occurred during sleep.
METHODS
Forensic pathology sections from eight universities participated in the selection of subjects from 2013 to 2018. Data obtained from the checklist form were analyzed based on information at postmortem.
RESULTS
There were 259 SUDI cases consisting of 145 male infants and 114 female infants with a mean birth weight of 2888 ± 553 and 2750 ± 370 g, respectively. Deaths most frequently occurred among infants at 1 month of age (18%). According to population data as the control, the odds ratio (95% confidence interval) of mother's age ≤19 years was 11.1 (6.9-17.7) compared with ages 30-39. The odds ratio for the fourth- and later born infants was 5.2 (3.4-7.9) compared with the frequency of first-born infants. The most frequent time of day for discovery was between 7 and 8 o'clock, and the time difference from the last seen alive was a mean of 4.1 h. Co-sleeping was recorded for 61%, and the prone position was found for 40% of cases at discovery. Mother's smoking habit exhibited an odds ratio of 4.5 (2.9-5.8).
CONCLUSION
This study confirmed the trends that have been observed for sudden infant death syndrome; particularly, very high odds ratios were evident for teenage mothers and later birth order in comparison with those in other developed countries. Neglect was suspected in some cases of the prolonged time to discovery of unreactive infants. To our knowledge, this is the first report of an extensive survey of SUDI during sleep in Japan.

Identifiants

pubmed: 32822352
doi: 10.1371/journal.pone.0233253
pii: PONE-D-20-12699
pmc: PMC7444554
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0233253

Déclaration de conflit d'intérêts

The authors have declared no competing interests exist.

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Auteurs

Motoki Osawa (M)

Department of Forensic Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan.

Yasuhiro Ueno (Y)

Department of Legal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.

Noriaki Ikeda (N)

Department of Forensic Pathology and Sciences, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan.

Kazuya Ikematsu (K)

Department of Forensic Pathology and Science, Graduate School of Biomedical Sciences Nagasaki University, Nagasaki, Japan.

Takuma Yamamoto (T)

Department of Legal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.

Wataru Irie (W)

Department of Legal Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.

Shuji Kozawa (S)

Department of Forensic Medicine and Sciences, Mie University School of Medicine, Tsu, Mie, Japan.

Hirokazu Kotani (H)

Department of Forensic Medicine and Molecular Pathology, Kyoto University Graduate School of Medicine, Kyoto, Japan.

Hideki Hamayasu (H)

Department of Forensic Medicine and Molecular Pathology, Kyoto University Graduate School of Medicine, Kyoto, Japan.

Takehiko Murase (T)

Department of Forensic Pathology and Science, Graduate School of Biomedical Sciences Nagasaki University, Nagasaki, Japan.

Keita Shingu (K)

Department of Forensic Pathology and Science, Graduate School of Biomedical Sciences Nagasaki University, Nagasaki, Japan.

Marie Sugimoto (M)

Department of Legal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.

Ryoko Nagao (R)

Department of Forensic Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan.

Yu Kakimoto (Y)

Department of Forensic Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan.

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