Sudden Unexpected Death in an Infant (SUDI)

Question 1

Most Sudden Unexpected Deaths in Infancy actually do have a cause. TRUE/FALSE?

Answer 1

TRUE

Question 2

SUDI applies to all deaths of infants up to what age?

Answer 2

Up to 1 year

Question 3

What is put on an infants death certificate if no cause of death is identified at post mortem?

Answer 3

SUDI can be put as cause of death

Question 4

What is meant by Sudden Infant Death Syndrome (SIDS)?

Answer 4

Subset of SUDI where no risk factors or pathological cause of death were identified

Question 5

What is the incidence of SUDI and what causes this to vary?

Answer 5

Between 1:1000 to 1:4000
Varies by
- country
- ethnicity
- social deprivation

Question 6

SUDI is the most common cause of infant death at what age?

Answer 6

Between 2-6 months

not most common in neonatal period

Question 7

Why does a SUDI at 12 months of age prompt to look harder for cause of death?

Answer 7

SUDI is much rarer at this age and stage

Question 8

What ethnicities are at higher risk of SUDI?

Answer 8

Maori and pacific population

Question 9

What is the triple risk model in relation to SUDI?

Answer 9

Infant has a vulnerability already (e.g. preterm, or maternal smoking in preg.)

An exogenous stress then occurs (prone position, overheating, infection etc)

This occurs at a critical time in their development and therefore causes a larger impact on the infants life - SUDI

Question 10

What risk factors for SUDI cannot be changed or prevented?

Answer 10

• period of acute illness
• preterm birth
• congenital anomaly
• multiple birth
• previous unexplained infant death
• SGA
• Boys more at risk

Question 11

What risk factors for SUDI potentially can be preventable?

Answer 11

• depression in mother at time of stillbirth
• alcohol/substance misuse
• smoking
• poor housing/domestic violence
• co-sleeping with child
• sleeping baby prone or on side
• sleeping on pillow/soft surface

Question 12

The Scottish Cot Death Trust aim to educate parents on the rules of safer sleep. What are these?s

Answer 12

• Back to sleep
• Clear cot (no teddies, pillows etc)
• Tuck in (blankets under arms)
• Feet to the foot of the cot (so baby doesnt move into unsafe position)
• uncover head so baby doesn’t get too hot

Question 13

How is SUDI usually investigated?

Answer 13

Multi-agency

POLICE often involved as death is unexpected => may be treated as suspicious

Question 14

Most episodes of SUDI occur at home, in the community. TRUE/FALSE?

Answer 14

TRUE

Question 15

Who is responsible for reporting SUDIs to the POLICE if they occur in the community?

Answer 15

Ambulance service that attend the house OR A and E if the baby is brought there

Question 16

If a post mortem is ordered by the procurator fiscal, it cannot be overturned by the baby’s family. TRUE/FALSE?

Answer 16

TRUE

Question 17

How long does a post mortem usually take before the results can fully be given to families?

Answer 17

3-4 months

Question 18

What are the most common causes of SUDI?

Answer 18

• infection (not recognised as life threatening at the time)
• congenital malformations
• Accidents (smothering => asphyxiation)
• NAI (head injuries due to shaking)

Question 19

Viral infection of which organ is most common in infants and may play a role in SUDI?

Answer 19

Myocarditis

Question 20

What bacterial infections are most commonly causes of SUDI?

Answer 20

Pneumonia/ SEPSIS

Question 21

In what percentage of cases is the cause of SUDI visible on macroscopic post-mortem examination?

Answer 21

30%

Question 22

What may you consider educating families on if they are considering further pregnancies?

Answer 22

Infant CPR