title: Sudden infant death syndrome and unascertainable deaths: trends and disparities among Aboriginal and non-Aboriginal infants born in Western Australia from 1980 to 2001 inclusive.
abstract: OBJECTIVE
  To analyse patterns and trends in mortality from unknown causes (sudden infant death syndrome and unascertainable deaths) for all Aboriginal and non-Aboriginal infants born in Western Australia, 1980-2001.
  
  
  METHODS
  Using total population linked data, we reviewed all post-mortem reports, including death scene investigations and final causes of death as ascertained by the coroner. Neonatal, post-neonatal and infant mortality rates attributed to unknown causes were calculated and the latter were analysed according to maternal age, geographical location, gestational age, sex and birthweight. Relative risks (95% confidence interval) for Aboriginal infants (compared with non-Aboriginal) were calculated.
  
  
  RESULTS
  The proportion of deaths considered to be of unascertainable cause has significantly increased in recent years. In contrast to the non-Aboriginal population, there has been no significant decrease in deaths in the Aboriginal population and the overall relative risk for Aboriginal infants for the most recent years studied was 7.9 (95% confidence interval 5.1-12.2). The relative risk was significantly increased for most categories analysed.
  
  
  CONCLUSIONS
  Reviewing post-mortem reports enabled identification of changes in the classification of deaths due to unknown causes. This provided a more accurate picture of the patterns and long-term trends of such deaths so that programmes can be developed to specifically target those groups most at risk. Adequately funded and evaluated education campaigns aimed at reducing the risk of sudden infant death syndrome among Aboriginal infants are required, as well as sustaining the current efforts that have been so successful for non-Aboriginal infants.
authors.affiliation: Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Perth, Australia. janef@ichr.uwa.edu.au
authors.forename: C Jane
authors.initials: CJ
authors.lastname: Freemantle
authors.forename: Anne W
authors.initials: AW
authors.lastname: Read
authors.forename: Nicholas H
authors.initials: NH
authors.lastname: de Klerk
authors.forename: Daniel
authors.initials: D
authors.lastname: McAullay
authors.forename: Ian P
authors.initials: IP
authors.lastname: Anderson
authors.forename: Fiona J
authors.initials: FJ
authors.lastname: Stanley
mesh_terms: D002423:Cause of Death / Q000639:trends*; D016208:Databases, Factual; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D013398:Sudden Infant Death / Q000453:epidemiology*; D014904:Western Australia / Q000453:epidemiology