Sudden infant death syndrome and other sleep-related infant deaths (case study of the Republic of Komi)

Introduction. The sudden infant death syndrome (SIDS), accidental asphyxia and suffocation in bed are the most significant part of the conditions united by the term "sudden unexpected death in infants" (SUDI). A high level of SUDI and a significant proportion in infant mortality are typical for countries with low rates of infant and babies mortality. The aim of the research is to study the epidemiological characteristics and risk factors of the sudden infant death syndrome in the Komi Republic from 1997 to 2015, to assess the contribution of SIDS, occasional asphyxia and suffocation in bed to the mortality of infants to determine the optimization of approaches to the prevention of these conditions. Materials and Methods. The retrospective data analysis of the death of infants has been performed according to medical records, protocols of pathoanatomical studies, and the conclusions of the infant mortality commission of the Ministry of Health of the Komi Republic from 1997 to 2015. Risk factors were assessed retrospectively on the scale of life-threatening conditions (Tsinserling A.V. and co-authors, 1987). Results. The cumulative infant mortality rate from SIDS was 0.63 ± 0.33 99o (median - 0.55 9). Within the past 5 years, when the infant mortality rate in the region has not changed significantly, averaging 5.22 ± 0.73 99o, the infant mortality rate from SIDS was 0.40 ± 0.25 99o (median 0.43). This compares with the level registered in the USA (0,49 in 2013) and in Western Europe with a similar level of infant mortality. In infant mortality of in the post-neonatal period, SIDS occurred in 13.8 ± 6.3 % (median - 12.2 %). Generally recognized data on the significant contribution of social and biological factors to decreasing the risk of sudden death syndrome were confirmed. The scale of life-threatening conditions showed the high sensitivity to death from SIDS. An examination of the place accident and assess of death circumstances is established to be absent in 61.3 % of cases of SIDS. Accidental asphyxia and suffocation in bed have accounted for 40 % in the structure of infant mortality from external causes. 70 % of cases are caused by the violation of infant safe sleeping space standarts. Discussion and Conclusions. It is necessary to intensify measures to prevent infant deaths associated with sleep. First, this is an explanatory work being performed already at the stage of pregnancy planning, aimed at women's and their environment's denying from bad habits. It seems reasonable to implant the national program to optimize conditions of safe infant sleeping environment, to support and preserve breastfeeding. The development and implementation of a single algorithm for assessing the circumstances of infant death at the prehospital stage will allow unifying approaches to diagnosis and optimizing the preventive measures to reduce infant deaths associated with sleep.