These causes of death account for essentially 100% of child deaths, underscoring the rarity of SUDC around the globe.Įven in the United States, with a well-established vital records registry, standards vary widely among the 2,300 medical examiner and coroner jurisdictions regarding which deceased individuals will be examined post-mortem, who performs the autopsy, concomitant toxicology and other ancillary testing, organ sampling, tissue retention, and duration of storage. Importantly, almost half of all deaths in children under 5 are attributable to undernutrition ( 7). Worldwide ( 6), the main causes of death of children under the age of 5 in 2015 included preterm birth complications (18%), pneumonia (16%), intrapartum-related complications (12%), diarrhea (9%), and sepsis/meningitis (9%). A substantial amount of information available for mortality for children aged less than 5 years is based on the collection of birth histories, verbal autopsy, disease modeling, and other strategies in absence of a civil registration system. The United Nations (UN) and World Health Organization (WHO) are proponents of Sample Vital Registration with Verbal Autopsy (SAVVY) ( 5) for most countries attempting to develop a system of Vital Records. Globally speaking, performance of a complete autopsy, especially when supplemented by ancillary studies, is uncommon. Only one-third of 55 million global deaths per year are tracked in an established civil registry ( 3), and only one-quarter of the global population lives in a country that registers at least 90% of births and deaths ( 4). For the purposes of this chapter, discussion is limited to deaths that occurred during a sleep period. In 2005, Krous and colleagues ( 2) provided the working definition of SUDC: “he sudden and unexpected death of a child over the age of 1 year that remains unexplained after a review of the clinical history and circumstances of death and performance of a complete autopsy with appropriate ancillary testing”. These deaths deserve extensive investigation and merit dedicated research in an attempt to uncover any potential cause(s) of death in the young child. Also, risk factors for SIDS (tobacco smoke exposure, placed prone for sleep, bed sharing) have not been shown to be risk factors for SUDC. There are two main differences between SIDS and SUDC: SIDS is much more common, with a rate of 38.7 deaths per 100,000 live births this compares to the SUDC rate of 1.0-1.4 deaths per 100,000 of the population and SIDS affects infants up to the age of 1 year, and SUDC affects mostly toddlers, aged greater than 1 year (highest incidence in 1-4-year-olds). Sudden infant death syndrome (SIDS) and sudden unexplained death in childhood (SUDC) are assigned as “causes” of death after the exclusion of any other known reason ( 1). Sudden Unexplained Death in Childhood DefinedĪlthough many sudden deaths are unexpected, deaths that remain unexplained intensify anguish among family, friends, and the community at large, especially when the decedent is an infant or child.
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