Infant Journal
for neonatal and paediatric healthcare professionals

NCMD report describes vulnerability factors in SIDS

A report from the National Child Mortality Database (NCMD) Honorary Senior Public Health Specialist Dr Helen Duncan, investigates factors that make infants vulnerable to sudden, unexpected and unexplained death (sudden infant death syndrome, SIDS).

A thematic review of vulnerability, which increases the risk of poor outcomes, in infants aims to describe and evaluate the factors that may increase the vulnerability of infants to this kind of death, examining pre-existing risk factors in the child, their family or their social or physical environment, which make them more vulnerable than average to poor outcomes or harm. The key findings are:

  • 98.1% of cases had at least one vulnerability factor identified from among clinical, statutory, family or social and environmental vulnerability factors
  • the most commonly occurring clinical vulnerability factors include an underlying health condition (60.9%) and the infant being described by their parents or carers as unwell on the day of death (50.0%). Over a third of cases identify smoking in pregnancy (39.1%), a recent illness (39.1%) and prematurity (37.5%)

  • more than four in 10 cases are known to social services, either previously or currently

  • the most commonly occurring family or social vulnerability factors, identified in over half of cases, are smoking in either parent and poor mental health in either parent. Over a third of cases identified previous domestic abuse (not directly related to the death) and smoking in both parents. Drug misuse and alcohol misuse have been identified as separate issues; recorded for either parent they are identified in over a quarter of cases

  • the most common occurring environmental vulnerability factor identified is not following advice and guidance on safe sleeping (78.1% of cases) and co-sleeping (51.6%). In 15.6% of cases the co-sleeping was unplanned and the carer was under the influence of drugs or alcohol.

Read the report at www.ncmd.info/publications/infants-sudden-unexplained-death

The NCMD report found that 98.1% of cases had at least one ‘vulnerability factor’.