Largely because of the national Back to Sleep campaign's effort to reduce prone sleeping rates, SIDS rates have declined by more than 50% since 1990. However, studies have shown that since 1999, some deaths previously classified as SIDS are now classified as due to accidental suffocation or unknown/unspecified cause. This finding suggests that changes in reporting of cause of death may account for part of the recent decrease in SIDS rates.

By definition, SIDS can be diagnosed only after a thorough examination of the death scene, a review of the clinical history, and performance of an autopsy fail to find an explanation for the death. Yet we know that some SUID are not investigated and, when they are, cause-of-death data are not collected and reported consistently. This causes concern because inaccurate classification of cause and manner of death ultimately impedes prevention efforts due to the fact that researchers cannot adequately monitor national trends or evaluate prevention programs.

CDC, in partnership with many others, launched an initiative in 2004 to improve the investigation and reporting of SUID. Other federal agencies and organizations representing medical examiners, coroners, death scene investigators, emergency medical personnel, law enforcement officials, forensic nurses, SIDS researchers, infant death review experts, and  parents who had experienced a death of an infant all contributed to this effort. As a result of this collaboration, March 1, 2006, CDC released the Sudden, Unexplained Infant Death Investigation (SUIDI) Reporting Form for state and local use in infant death scene investigations. The SUIDI Reporting Form replaces the Investigation Report Form that accompanied the 1996 Guidelines for the Death Scene Investigation of Sudden, Unexplained Infant Death.

Training

Prior to CDC's SUID Initiative, no national training materials on how to investigate an infant death scene were available. In collaboration with a steering committee and a team of national experts, CDC developed a comprehensive training curriculum and materials for infant death scene investigations. Training materials highlight infant growth and development, interviewing and investigative skills, scene recreation using a doll, and how to fill out a death certificate.

CDC will use these materials to train investigators and death certifiers how to consistently collect data at the death scene and accurately report their findings on the death certificate. CDC is conducting five regional Train-the-Trainer Academies.

Surveillance

CDC is working with the states to collect standardized information about the circumstances surrounding infant deaths—in particular, about the sleep environment as well as about the conduct and quality of the death scene investigation. National vital statistics data do not provide this information. In addition to death certificates, data sources include the SUIDI Reporting Form or equivalent, law enforcement records, EMS records, and medical records. These standardized data will allow CDC and its partners to quantify the extent of classification and reporting concerns. With this knowledge, CDC and its partners will be better able to monitor trends in SUID and identify risk factors. Once ongoing surveillance is established, CDC will be able to

• Monitor trends in SUID at the state, regional, and local level.
• Identify new risk factors associated with SIDS and other SUID.
• Develop and evaluate strategies and interventions to prevent SUID.
• Assist in identifying cases for research studies.

Page last reviewed: 6/21/07
Page last modified: 6/21/07
Content source: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion