Sudden infant death syndrome among the Auckland Pacific communities 1988-1996: is it increasing?

Aims: To define ethnic origin and verify the diagnosis of sudden infant deaths among Pacific peoples in Auckland 1988-1996, and to elicit soci-econonic and demographic characteristics.
Methods: Police (P47) and coroner reports were analysed for an ethnic classification and diagnosis. Postneonatal and sudden infant death syndrome (SIDS) register and New Zealand Information Services data were analysed for additional Pacific cases. Rates of Pacific SIDS in Auckland calculated. A Pacific SIDS database was developed and families were tracked. Face to face interviews covering the SIDS event were undertaken with selected families. Data were coded, stratified and a thematic approach to analysis was utilised.
Results: There were 52 cases of SIDS and the ethnic origins were: thirteen Samoans, nine Cook Islanders, seven Togans fifteen multiple ethnicity, and eight could not be verified. The annual rates of Pacific SIDS varied from less than one (in 1989) to 4.5 (in 1995) per 1000 Pacific live births. 34 cases (65%) couldd not be contacted and eighteen were traced. Nine in-epth interviews were conducted with caregivers of these cases. All babies had slept in the supine position, seven were breasted, and five of the mothers were non-smokers. Eight babies sept in the same room with their primary caregiver, with seven sleeping in their own bed. All of the mothers had had continuous access to childcare and support from their families, and seven had had previous children. Grief counselling for partners and children was identified as necessary by almost all the mothers. CNCLUSIONS: This preliminary study concludes that the rate of Pacific SIDS increased in 1995 and remains a serious problem. Ethnic misclassification and under reporting of SIDS cases is apparent among Pacific infants. There is a need to establish a national infant mortality database that collects accurate data incorporating standardised ethnic specific categories. Official routine and data sources also need to incorporate standardised ethnic specific categories. A national prospective study is required to study SIDS in Pacific communities as a basis for effective prevention strategies.