Increase in trauma and sudden unexpected death syndrome in children

The number of babies and children dying due to trauma and sudden unexpected death syndrome has seen an increase according to a new study. Researchers from the University of Bristol’s National Child Mortality Base (NCMD), the study looked at pre and post pandemic child mortality rates from 1 April 2019 to 31 March 2022.

It also highlighted that the findings indicated there was little impact on child mortality rates when considering disruption to health services due to the pandemic and potentially late or undiagnosed conditions.

The University of Bristol said the research was a “first-of-its-kind initiative to collect comprehensive and timely information on every child death in England.” The primary objective of the study was to identify risks or patterns of child deaths over three 12 month periods.

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Over this three year period, there were 9872 child deaths, with 63% occurring under one year of age, 56% being male and 89% living in an urban area.

The first twelve month period, which was prior to the pandemic recorded 3409 deaths in England, but during the second period – the first year of the pandemic – deaths were reduced to 3035. The third period saw a rise to 3428 deaths.

According to the study, the significant drop in the pandemic’s first year was due to a decreased number of infections in younger children. With regard to the whole period, research showed a 22.8% reduction in the number of deaths caused by infection, with a 13.3% reduction in underlying disease.

“But in contrast to most deaths, those from trauma have increased 14.8% across the three years and this association does not appear to be restricted to one particular age group. There has also been an increase in sudden unexpected death in infancy or childhood (SUDIC), this may be the first mortality signal we are seeing from families struggling with increasing poverty as we move out of the pandemic,” stated the release.

The trauma category included accidental and non-accidental deaths, such as isolated head injury, other or multiple trauma, burn injury, drowning, unintentional self-poisoning in pre-school children, anaphylaxis and other accidental factors. Professor of Neonatal Medicine at the University of Bristol and NCMD Programme Lead, Karen Luyt said: “The increase that we have identified largely represents accidental deaths from traffic collisions, drowning, and other risks that were suppressed during lockdown”.

She added that the number of non-accidental deaths remains small at population level. With regard to sudden unexplained deaths showing a 2.7% increase (for all age groups, not just infants), the cost of living crisis could be a key factor.

Luyt referred to other investigations by NCMD which indicated that sudden unexplained deaths of infants and children were far more likely to occur in the poorest areas. “For under one year olds, 42% of SUDIC deaths were in the most deprived neighbourhoods and 8% in the least,” she said.

Overall she said the latest research over the three years showed that : “the number of deaths of children in England dropped substantially during the first year of the pandemic but returned to baseline levels in the following year. However, there was little to suggest an excess of deaths in 2021-22 overall”.

“Disruption to healthcare services, and potentially later diagnoses or underdiagnosed conditions, appear not to have had a measurable impact on mortality. It is important that we learn from the effects highlighted in this study to improve the outcome for the most vulnerable children in our society and identify interventions which can help prevent deaths in future,” she said.

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