title: Sleep-Related Infant Deaths in Victoria: A Retrospective Case Series Study.
abstract: BACKGROUND
  There is general agreement that in some circumstances, sharing a sleep surface of any kind with an infant increases the risk of sudden unexpected death in infancy. There is a paucity of research conducted in Australia examining this issue. This study examines the frequency and distribution of sleep-related infant deaths in a defined population, and reports the proportion that occurred in the context of bed-sharing.
  
  
  METHODS
  A retrospective population-based case series study was conducted of infants (≤365 days) who died in a sleeping context during the period 1 January 2008 to 31 December 2010 in the state of Victoria, Australia. Information about the infant, caregiver, sleeping environment and bed-sharing was collected from a review of the coroner's death investigation record.
  
  
  RESULTS
  During the 3-year study period, 72 infant deaths occurred in a sleeping context. Of these, 33 (45.8 %) occurred in the context of bed-sharing: n = 7 in 2008; n = 11 in 2009; and n = 15 in 2010. Further analysis of the 33 deaths occurring in the context of bed-sharing showed that in this group, bed-sharing was largely intentional, habitual and most often involved the mother as one of the parties.
  
  
  CONCLUSIONS
  Given the case series nature of the study design, a causal relationship between bed-sharing and infant death could not be inferred. However the fact that nearly half of all sleep-related deaths occurred in the context of bed-sharing, provides strong support for the need to undertake definitive analytic studies in Australia so that evidence-based advice can be provided to families regarding the safety of bed-sharing practices.
authors.affiliation: Monash Injury Research Institute, Monash University, Clayton, VIC, 3800, Australia. lyndal.bugeja@monash.edu.|Coroners Court of Victoria, Southbank, VIC, 3006, Australia. lyndal.bugeja@monash.edu.
authors.forename: Lyndal
authors.identifier: http://orcid.org/0000-0003-0547-710X
authors.initials: L
authors.lastname: Bugeja
authors.affiliation: Coroners Court of Victoria, Southbank, VIC, 3006, Australia.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Dwyer
authors.affiliation: Coroners Court of Victoria, Southbank, VIC, 3006, Australia.
authors.forename: Sara-Jane
authors.initials: SJ
authors.lastname: McIntyre
authors.affiliation: University of the Sunshine Coast, Sunshine Coast, QLD, 4556, Australia.
authors.forename: Jeanine
authors.initials: J
authors.lastname: Young
authors.affiliation: Monash Injury Research Institute, Monash University, Clayton, VIC, 3800, Australia.
authors.forename: Karen Lesley
authors.initials: KL
authors.lastname: Stephan
authors.affiliation: Harvard School of Public Health, Boston, MA, USA.
authors.forename: Roderick John
authors.initials: RJ
authors.lastname: McClure
mesh_terms: D000328:Adult; D001315:Australia; D001512:Bedding and Linens; D001513:Beds; D002648:Child; D005260:Female; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D008297:Male; D009035:Mothers; D011159:Population Surveillance; D011187:Posture; D016684:Prone Position; D012189:Retrospective Studies; D012307:Risk Factors; D012890:Sleep / Q000502:physiology; D013398:Sudden Infant Death / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D016683:Supine Position; D014739:Victoria / Q000453:epidemiology
keywords: Bed-sharing; Fatal sleep accidents; Infant; Sudden infant death syndrome; Sudden unexpected deaths in infancy