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Incidence of sudden unexplained death in childhood for children aged 1–14 years in England and Wales during 2001–2020: an observational study
  1. Joanna Jane Garstang1,2,
  2. Merve Tosyali3,4,
  3. Marivjena Menka5,6,
  4. Peter S Blair7
  1. 1School of Nursing and Midwifery, College of Medicine and Health, University of Birmingham, Birmingham, UK
  2. 2Children and Families Division, Birmingham Community Healthcare NHS Foundation Trust, Birmingham, UK
  3. 3Pediatrics, Ege Universitesi, Izmir, Turkey
  4. 4University of Birmingham, Birmingham, UK
  5. 5Research and Development, Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, UK
  6. 6School of Nursing and Midwifery, College of Medical and Health, University of Birmingham, Birmingham, UK
  7. 7Centre for Academic Child Health, University of Bristol, Bristol, UK
  1. Correspondence to Dr Joanna Jane Garstang; j.garstang{at}bham.ac.uk

Abstract

Objective The objective is to determine the incidence of sudden unexplained death in childhood (SUDC) for children aged 1–14 years in England and Wales during 2001–2020.

Design Observational study using official national statistics on death registrations and child population.

Setting England and Wales.

Patients Children dying of SUDC, aged 1–14 years, registered as International Classification of Disease version 10 codes R95–99.

Main outcome measures Incidence of SUDC, proportion of child mortality due to SUDC.

Results A total of 582 children aged 1–14 years died of SUDC, 450 (77.3%) deaths were in children aged 1–4 years, 55 (9.5%) in those aged 5–9 years and 77 (13.2%) in those aged 10–14 years. The number of SUDC was relatively stable with a mean of 29 cases per year (range 21–38, SD 4.2). Overall child mortality fell from 1482 deaths in 2001 to 826 in 2020. The incidence of SUDC for children aged 1–14 years ranged between 0.002 and 0.004 per 1000. The relative proportion of child mortality due to SUDC increased from 1.96% of all child deaths in 2001 to 3.03% in 2020 (p=0.103), SUDC accounted for 5.8% of deaths of children aged 1–4 years by 2020. At all ages, SUDC was more common in male children than female children.

Conclusion The incidence of SUDC has remained static despite overall child mortality almost halving in the last two decades. SUDC is now more widely recognised due to improved investigation, but there has been limited research into SUDC; potential causes and associated risk factors remain unknown. As the relative proportion of child deaths due to SUDC increases, child health professionals must be aware of SUDC to support bereaved families.

  • Child Health
  • Epidemiology
  • Mortality
  • Paediatrics

Data availability statement

All data relevant to the study are included in the article or uploaded as online supplemental information. All data used in the study are available in online supplemental table 1. Further information on the data is available on reasonable request to the corresponding author (JJG).

https://doi.org/10.1136/archdischild-2024-327840

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    Data availability statement

    All data relevant to the study are included in the article or uploaded as online supplemental information. All data used in the study are available in online supplemental table 1. Further information on the data is available on reasonable request to the corresponding author (JJG).

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    Footnotes

    • Contributors JJG conceived the study idea. All authors (JJG, MM, MT and PSB) contributed to study design, MM and MT collected data and conducted analyses which were agreed by all authors. JJG wrote the first draft of the paper, with help from all authors, who all contributing to reviewing and editing. All authors provided final approval of the version to be published. JJG is guarantor.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests JJG is paid by the National Child Mortality Database as a specialist clinical advisor. She has been paid for developing and delivering educational presentations relating to Child Death for the Primary Care Conference, Stirling Events. She acts as expert witness for legal cases related to sudden child death, has received funding from the Lullaby Trust and SUDC-UK (Sudden Unexplained Death in Childhood) to attend scientific meetings overseas; and is Chair of the Association of Child Death Review Professionals (UK), medical advisor to SUDC-UK and a member of the Lullaby Trust scientific committee no other relationships or activities that could appear to have influenced the submitted work. MT, MM and PB declare no competing interests.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.