Sudden infant deaths in sitting devices

Abstract

Episodes of decreased oxygenation levels have been recorded in prematurely born infants positioned in car seats. It is therefore believed these infants travelling in car seats are at risk of life-threatening events and even death. No data on the prevalence of such infant deaths are available. The aim of our study was to determine the incidence of sudden deaths occurring in sitting devices in a whole population and to determine whether prematurely born infants represent a disproportionate number of these deaths.

Design: Retrospective population based cohort study reviewing all cases of sudden unexpected death in infants between 0 and 365 days of age that occurred in the province of Quebec between January 1991 and December 2000.

Results: Of the 508 deaths reviewed, 409 were unexplained and 99 were explained after investigation. Seventeen deaths occurred in a sitting device, of which 10 were unexplained deaths. There was no excess of prematurely born infants dying; there was, however, an excess of infants of less than one month of age found to have died in a sitting position in the unexplained death group. In addition, three infants had an increased risk of upper airway obstruction.

Conclusion: Although very few deaths occurred in car seats, our results would suggest that caution be used when placing younger infants in car seats and similar sitting devices, whether the infants had been born prematurely or not. We also recommend that more attention be given to infants at increased risk of upper airway obstruction.