Intended for healthcare professionals


Infant respiratory death rates mirror sudden infant deaths

BMJ 1995; 310 doi: (Published 17 June 1995) Cite this as: BMJ 1995;310:1603
  1. D L Crombie,
  2. K W Cross,
  3. D M Fleming
  1. Research consultant Statistical consultant Director Birmingham Research Unit, Royal College of General Practitioners, Birmingham B17 9DB

    EDITOR,—E A Gilman and colleagues speculate about the reasons for the dramatic falls in sudden infant deaths that occurred during the first and second quarters of 1992 as compared with the decreasing trends in the rates for these two quarters over the previous four years.1 The dramatic falls occurred after the launch of the campaign to encourage parents to put infants to sleep on their backs and to avoid smoking near them or overheating them.

    The authors put forward as one possible explanation of these falls the interaction between the prone sleeping position and the underlying pathogenic mechanisms that it affects. In this regard, we would draw attention to the fact that the secular and seasonal trends in the monthly numbers of sudden infant deaths over recent years have been mirrored by those for infant deaths attributable to respiratory disease. The figure shows the two series for the years 1986-92. The concordance between these two series is evident in the summer troughs as well as the winter peaks. This phenomenon suggests that whatever has led to the seasonal variation and decreasing trend in sudden infant deaths, including the pronounced decrease during 1992, has produced a similar pattern for infant deaths attributable to respiratory disease. Furthermore, we have shown that during 1986-90 there was a close association between the monthly incidence of respiratory infectious diseases in the age group 0-4 years.2


    Numbers of sudden infant deaths and infant deaths attributable to respiratory disease, England and Wales, 1986-92 (source: Office of Population Censuses and Surveys)


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