69 Infant Mortality in Car Seats

Cardiorespiratory events and episodes of decreased oxygenation have been reported in infants positioned in car safety seats. It is believed that former premature infants travelling in car seats are at risk of life-threatening events and it has been postulated that this could eventually cause sudden death. However, there is no data available on the prevalence of such events. The aim of our study was to determine exactly the incidence of infant sudden death occurring in car seats or similar devices.

We reviewed retrospectively the circumstances of death in all cases of sudden unexpected death between 0 and 1 year of age from 1991 to 2000 in the province of Quebec.

During the 10-year period of interest, there have been 501 cases of sudden and unexpected deaths of non-accidental nature of which 409 were of no apparent cause (sudden infant death, SID). The exact circumstances and positioning at the moment of death are known for 96% of the cases. 13 deaths occurred while the victim was in a sitting position of which 8 were a SID (2% of 409). Of these 8 cases, only 4 occurred while travelling in a car seat, the others were at home in a car seat or a similar device. 38% of the infants dying in a sitting position were younger than one month old whereas only 13% were younger than one month in the group not found in sitting position (p<0.01). The proportion of premature babies was not different between these two groups.

Few deaths occur in car seats or similar devices in our population. Nevertheless, many of these deaths occur in young infants; we should therefore continue the recommendation to limit car seat travelling and their duration for these infants. In addition, we should consider limiting the use of car seats or similar devices at home because sudden death also occur in these circumstances.