6. DISCUSSION

6.1 The on-going decline in the SIDS rate in the Republic of Ireland is welcomed. The rate from 1988 to 1995 represents a 70% drop (2.3 v 0.7/1,000), yet SIDS remains a leading cause of death in infants aged four weeks to one year.

6.2. It is imperative that interpretation of data based on small numbers is viewed with caution. The potential influence of random variation must be also considered and data may require to be monitored over time before being interpreted.

6.3 The availability of on-going, accurate information on SIDS in Ireland, coupled with the excellent participation of families and professionals in a variety of SIDS-related research projects, provides an essential data base to monitor emerging trends.

6.4 The change in the seasonal characteristic of SIDS (absence of winter peak) noted in 1994 and 1993 is upheld in 1995.

6.5 The consistency of greater parental unemployment and medical card status among SIDS families than the national average figures for 1992, 1993, 1994 and 1995 raises questions that require further investigation.

6.6 With regard to the 'Reduce the Risks of Cot Death' guidelines the persistence of high level of smoking among SIDS families poses questions regarding the effectiveness of existing education programmes. Furthermore, the 1995 data upholds the principal that the lateral sleeping position is unstable and uniform promotion of the supine (back) sleeping position by professionals and the media is required.

7. FUTURE DIRECTION

7.1 National control data now being collected will considerably enhance evaluation of the findings outlined. Findings from the two year case control study (1994-1995) will be reported at a later date. At the same time, the on-going collection of data by the Register will ensure that emerging trends are monitored over time.

7.2 Collaboration with European Research

During 1995 the National Sudden Infant Death Register continued to participate in the European 'Concerted Action' SIDS research project (completed on 31st December 1996). Funded by the European Union, the study encompasses fifteen centres in twelve countries throughout Eastern and Western Europe which are gathering SIDS Case Control data. The National Sudden Infant Death Registrar is a member of the project's Steering Committee.

8. NATIONAL SUDDEN INFANT DEATH REGISTER RESULTS - PART THREE

1996 Provisional epidemiology data

8.1 The SIDS mortality rate in the Republic of Ireland over the past 15 years has fallen considerable and is currently almost one third of the rate which was seen throughout the 1980's. While the fall in the SIDS rate is greatly welcomed, SIDS still accounts for four in every ten deaths in the age group one month to one year.

8.1.1 Table 10 shows the total number of live births, total number of SIDS and the SIDS rate per 1,000 live births for the years 1980 to 1996 inclusive. In 1996, 45 suspected cases of Sudden Infant Death Syndrome were reported to the Register. Final postmortem details on all cases are awaited. Based on the birth figures for 1995 (48,530) this yields a SIDS rate of 0.9 per 1,000 live births. The corresponding SIDS rate in 1995 was 0.7/1,000, 1994 0.8/1,000 and in 1993 was 0.7/1,000.