Sudden Unexpected Infant Death (SUID) is a major cause of infant mortality with approximately 3,500 infants dying suddenly and unexpectedly in the US each year (accounting for 16% of all US infant deaths) and approximately 53 dying in Maryland yearly (accounting for 27% of all Maryland infant deaths). Inconsistencies in infant death scene investigations, SUID reporting, and SUID classification methods limit understanding of the factors associated with SUID and the ability to make comparisons, track trends and develop effective prevention programs.
The purpose of the proposed project is to strengthen public health surveillance and prevention of SUID in Maryland through the efforts of its Maryland State Child Fatality Review (CFR) Team. Proposed objectives include increasing access to high-quality and complete surveillance data for SUID; improving the completeness, timeliness and quality of SUID surveillance data for program improvement and public health purposes; establishing the incidence of SUID by categorical type of SUID; developing data briefs and other products to inform programs and key stakeholders; and increasing awareness of SUID associated factors and disparities, particularly in disproportionately impacted communities.
Specific activities proposed under this initiative include identifying all cases for child death review within 30 days of death; conducting a multidisciplinary child death review of all cases within 90 days of identification by having all data available for review; categorizing each SUID case at CDR meetings according to established algorithms; performing quality assurance checks on all cases within 90 days of entering case information; and analyzing and disseminating data to inform practice and policy change. The Maryland CFR program will also work with the Office of the Chief Medical Examiner (OCME) to standardize all infant death scene investigations; offer trainings on doll reenactments; enhance the current OCME database to provide local CFR teams with access to more complete data; and link data directly to the National Child Death Review Case Reporting System (NCDR-CRS). The Maryland CFR program will fund up to 3 jurisdictions to develop and implement strategies and activities to prevent SUIDs in communities that are disproportionately impacted by sleep-related infant deaths. Finally, the Maryland CFR program will work with the OCME and Maryland’s Vital Statistics Administration to facilitate data transfers between the OCME database, birth and death certificate files, other relevant databases, and the NCDR-CRS, in order to capture more information regarding death circumstances.
The result of these efforts will be improved policies and practices of systems serving families at higher risk for SUID; improved policies to standardize investigation practices, including review of medical records, scene investigations and autopsies; improved policies to standardize death reporting practices; and reduced incidence of SUID and disparities in SUID in Maryland.
