Categories of preventable unexpected infant deaths

Article Abstract:

Since 1973, confidential inquiries into infant deaths have been carried out in Sheffield, Scotland. By 1988, it was clear that there had been a decline in the mortality of infants with potentially treatable disease, and an increase in the number of infant deaths due to relatively minor disease in which several factors contributed to the final outcome. The results of careful inquiry into the unexpected deaths of 115 infants over a period of nine years are reported and provide insight into the factors which contribute to preventable unexpected infant death. The average age at death was 16 weeks. Deaths were classified as resulting from a disease with a poor prognosis (7 deaths), a potentially treatable disease (45 deaths), minor disease (32), no disease (19), accidents (4), and probable infanticide (8). Fewer than 20 percent of these deaths could be attributed to sudden infant death syndrome (SIDS). It is curious to note that there was a predominance of males (16 of 19) among the infants who died without a fatal disease, and also a predominance of males (6 of 8) among the deaths which were suspected infanticide. In general, babies who died from either a potentially treatable disease or a minor disease came from similar backgrounds. Their mothers tended to be young, to smoke, and to have sought prenatal care only late in pregnancy. These families were less likely to own cars or telephones. Among the infants who died of only minor disease, the state of the mother's health, particularly depression, seemed to be especially important. Many of the babies in this group had a number of minor defects which were not in themselves serious, but which may have made the infants more susceptible to other illnesses. (Consumer Summary produced by Reliance Medical Information, Inc.)

Scotland, Infants, Infant mortality

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Late deaths after treatment for childhood cancer

Article Abstract:

The deaths of 749 patients who had survived at least five years after the diagnosis of childhood cancer before 1971 were assessed. Of 738 cases where sufficient information was available, death was due to recurrent tumor in 550 cases, a second primary tumor in 61 cases, treatment-related conditions in 49 cases, injury unrelated to tumor or treatment in 34 cases, and other causes unrelated to the tumor and treatment in 44 cases. Recurrent tumor was the cause of death in less than 10 percent of cases of patients with non-Hodgkin's lymphomas, neuroblastoma, retinoblastoma, Wilms' tumor, or a soft tissue sarcoma and in more than 25 percent of patients with Hodgkin's disease, ependymoma, medulloblastoma, and Ewing's tumor during the next 15 years. Death due to recurrent disease occurred in almost 50 percent of patients with acute lymphocytic leukemia during the next 15 years. Most of these deaths were due to central nervous system (CNS) relapse and occurred before the development of treatment to prevent CNS disease. The death rate was three times greater among cancer patients than in the general population. There were five times more deaths due to heart and blood vessel disorders, including heart attack and stroke, and three times more accidents in patients with central nervous system tumors. Deaths due to radiation-induced fibrosis, the formation of fiber-like tissue, and addisonian crises, a condition resulting from a deficiency in the secretion of adrenocortical hormones, could have been avoided. These deaths occurred in patients diagnosed with cancer before 1971, and the current pattern of mortality may be different due to improved effectiveness and extensive use of new chemotherapy regimens. (Consumer Summary produced by Reliance Medical Information, Inc.)

Prognosis, Cancer in children, Childhood cancer

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Decline in breast feeding

Article Abstract:

Breast-fed infants receive added nourishment and health benefits, such as immune factors, that infant formula cannot supply. During the 1970s, a renewed interest in breast-feeding emerged, but it appears that it has decreased in popularity again. A 15-year study was conducted in Great Britain to document breast-feeding patterns. The survey of 55,100 mothers included information on maternal age, intention to breast- or bottle-feed, ethnic group, previous pregnancies and their outcome (parity), and the age at which the mother finished full-time education (used as an index of socioeconomic status). A steady rise in the numbers of mothers actually breast-feeding was recognized during the 1970s, but since 1981, there was a continual decline in both the mothers' intentions to breast-feed and the actual rate of breast-feeding at one month after delivery, especially among Asian and less educated mothers. However, the high level of breast-feeding was maintained among older, more educated mothers. One possible explanation for the difference between the desire to breast-feed and actually doing so may be that more mothers are working outside the home. This study did not identify any one reason for the recent decline in the number of women breast-feeding in this population. (Consumer Summary produced by Reliance Medical Information, Inc.)

Services, Statistics, Breast feeding

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