A clinical comparison of SIDS and explained sudden infant deaths: how healthy and how normal?

Objectives-To compare the clinical characteristics associated with sudden i nfant death syndrome (SIDS) and explained sudden unexpected deaths int infa ncy (SUDI). Design-Three year population based, case control study with parental interv iews for each death and four age matched controls. Setting-Five regions in England (population, > 17 million; live births, > 4 70 000). Subjects-SIDS: 325 infants; explained SUDI: 72 infants; controls: 1588 infa nts. Results-In the univariate analysis, all the clinical features and health ma rkers at birth, after discharge front hospital, duping life, and shortly be fore death, significant among the infants with SIDS were in the same: direc tion among the infants who died of explained SUDI. in the multivariate anal ysis, at least one apparent life threatening event had been experienced by more of the infants who died than in controls (SIDS: 12% v 3% controls; odd s ratio (OR) = 2.55; 95% confidence interval (CH), 1.02 to 6.41; explained SUDI: 15% v 4% controls; OR = 16.81; 95% CI, 2.52 to 112.30). Using se retr ospective illness scoring system based an "Baby Check", both index groups s howed significant markers of illness in the last 24 hours (SIDS: 22% v 8% c ontrols; OR = 4.17; 95% CI, 1.88 to 9.24; explained SUDI: 49% v 8% controls ; OR = 31.20; 95% GI, 6.93 to 140.5). Conclusions-The clinical characteristics of SIDS and explained SUDI are sim ilar. Baby Check might help identify seriously ill babies at risk of sudden death, particularly in high risk infants.