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Determining the prevalence of sudden and unexplained death in childhood (SUDC): a national Australian perspective


Sudden unexplained death in childhood (SUDC) is defined as the unexplained death of a child over the age of 12 months. The National Coronial Information System (NCIS) Australia was used to access data for deaths of children aged 1 to 4 years over the period 2010 to 2014. Cases were classified as those in which the cause of death was determined and those in which the child died suddenly and unexpectedly, and the cause of death remained undetermined. Categorical information was extracted for each case to determine risk factors associated with the cause of death. The overall rate of death in Australian children aged 1 to 4 years and for whom coronial data was available from 2010 to 2014 was 9.69/100,000 children. A cause of death was determined in 87% of cases with the average rate of death in this group being 8.49/100,000. Death remained undetermined in 13% of cases. The study determined that the SUDC rate in Australian children aged 1 to 4 years was 0.02/100,000. However, this rate may be as high as 0.40/100,000 children should further investigation be undertaken. These children tended to be 18–20 months of age and male, with death occurring primarily while prone during a sleep period in cooler months, thus having similar characteristics to sudden infant death syndrome.

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Fig. 1


  1. 1.

    Krous HF, Chadwick AE, Crandall L, Nadeau-Manning JM (2005) Sudden unexpected death in childhood: a report of 50 cases. Pediatr Dev Pathol 8(3):307–319

    Article  Google Scholar 

  2. 2.

    McGarvey CM, O'Regan M, Cryan J, Treacy A, Hamilton K, Devaney D et al (2012) Sudden unexplained death in childhood (1-4 years) in Ireland: an epidemiological profile and comparison with SIDS. Arch Dis Child 97(8):692–697

    Article  Google Scholar 

  3. 3.

    Malloy MH, MacDorman M (2005) Changes in the classification of sudden unexpected infant deaths: United States, 1992-2001. Pediatrics 115(5):1247–1253

    Article  Google Scholar 

  4. 4.

    Statistics Ar-AD. (2017) Table 59: estimated resident population by single year of age, Australia. Accessed on 26th October 2017

  5. 5. (2017) A program for the Lucile Packard Foundation for Children's Health. Accessed 24 Nov 2017

  6. 6.

    Willinger M, James LS, Catz C (1991) Defining the sudden infant death syndrome (SIDS): deliberations of an expert panel convened by the National Institute of Child Health and Human Development. Pediatr Pathol 11(5):677–684

    CAS  Article  Google Scholar 

  7. 7.

    Krous HF, Beckwith JB, Byard RW, Rognum TO, Bajanowski T, Corey T et al (2004) Sudden infant death syndrome and unclassified sudden infant deaths: a definitional and diagnostic approach. Pediatrics 114(1):234–238

    Article  Google Scholar 

  8. 8.

    Kinney HC, Thach BT (2009) The sudden infant death syndrome. N Engl J Med 361(8):795–805

    CAS  Article  Google Scholar 

  9. 9.

    de Jonge GA, Engelberts AC (1989) Cot deaths and sleeping position. Lancet 2(8672):1149–1150

    Article  Google Scholar 

  10. 10.

    Byard RW (2001) Inaccurate classification of infant deaths in Australia: a persistent and pervasive problem. Med J Aust 175(1):5–7

    CAS  Article  Google Scholar 

  11. 11.

    Burnell RH, Byard RW (2002) Are these really sids deaths? Not by definition. J Paediatr Child Health 38(6):623–624 author reply 4-5

    CAS  Article  Google Scholar 

  12. 12.

    Kahn A, Wachholder A, Winkler M, Rebuffat E (1990) Prospective study on the prevalence of sudden infant death and possible risk factors in Brussels: preliminary results (1987-1988). Eur J Pediatr 149(4):284–286

    CAS  Article  Google Scholar 

  13. 13.

    Byard RW, MacKenzie J, Beal SM (1997) Formal retrospective case review and sudden infant death. Acta Paediatr 86(9):1011–1012

    CAS  Article  Google Scholar 

  14. 14.

    Mitchell E, Krous HF, Donald T, Byard RW (2000) An analysis of the usefulness of specific stages in the pathologic investigation of sudden infant death. Am J Forensic Med Pathol 21(4):395–400

    CAS  Article  Google Scholar 

  15. 15. (2017) ICD-10 codes R95-R99 from CDC Wonder Database. Accessed 24 Nov 2017

  16. 16.

    Byard RW (2010) Sudden Infant Death Syndrome. In: Byard RW, editor. Sudden death in the young, 3rd edn. Cambridge University Press, UK, pp 555–630

    Google Scholar 

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We would like to acknowledge the support of the Cooper Trewin Memorial SUDC Research Fund, the National Coronial Information System (NCIS) and the Department of Justice and Community Safety who manage the NCIS. We also acknowledge the Victorian Government’s state infrastructure program.

Author information




Dr. Jhodie Duncan conceptualized and designed the study, accessed the NCIS database and consolidated the raw data, carried out the initial analysis, drafted the initial manuscript and reviewed and revised the manuscript. Professor Roger Byard designed the study, assisted with study parameters, confirmed initial case diagnosis and reviewed and revised the manuscript for intellectual content. Both authors approve the finial manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Jhodie R. Duncan.

Ethics declarations

All procedures performed in studies involving human participants were in accordance with the ethical standards of the following institutional and/or national research committees (NCIS Research Committee (M0382), Victorian Department of Justice Human Research Ethics Committee (CF/16/19565), Western Australian Coronal Ethics Committee, Coroner’s Court of Victoria Research Committee and University of Melbourne Ethics Committee (1748597)) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Funding bodies had no involvement in the design, analysis and decision to publish. There are no conflicts of interest or financial disclosures in this work.

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Duncan, J.R., Byard, R.W. Determining the prevalence of sudden and unexplained death in childhood (SUDC): a national Australian perspective. Int J Legal Med 135, 793–800 (2021).

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  • Sudden unexplained death in childhood
  • Sudden infant death syndrome
  • Undetermined
  • Risk factor
  • Death