• Wei-Chieh Tseng, Mei-Hwan Wu, Sheunn-Nan Chiu, Hui-Chi Chen, Feng-Yu Kao, and San-Kuei Huang.
• Department of Emergency Medicine, National Taiwan University Hospital and Medical College, National Taiwan University, Taiwan; Graduate Institute of Clinical Medicine, National Taiwan University Hospital and Medical College, National Taiwan University, Taiwan.
• J Formos Med Assoc. 2020 Dec 1; 119 (12): 1842-1853.

BackgroundTo investigate the cumulative postnatal risk of pediatric sudden death (SD) for each neonate and the temporal/regional differences which are still unclear.MethodsWe established a birth cohort (2000-2014) from our national database and obtained reference data about the United States (US) from the national website.ResultsAmong 3,097,277 live births, we identified 1661 children with SD (56.8% male). The postnatal cumulative risk of SD was 0.35, 0.49, 0.56 and 0.59/1000 by age 0, 5, 11 and 14 years. Coexisting cardiac diagnosis was noted in 347 (20.9%) and non-cardiac diagnosis in 300 (18.1%) patients. Cumulative all-cause mortality was 5.3, 6.78, 7.63 and 8.06/1000 by age 0, 5, 11 and 14 years. Risks of SD and all-cause death decreased over birthyear. SD risk decreased particularly after the 2008 birthyear. Risks of SD and all-cause death were the highest in Eastern Taiwan, but SD/all-cause death ratio was high in Taipei metropolitan and Northern Taiwan. Cumulative risk of SD (0.54/1000 by age 14) and all-cause mortality (9.06/1000 by age 14) in the US decreased over time. African-Americans were at the highest risks of SD and all-cause mortality. However, American-Indians/Alaska-natives exhibited the highest SD/all-cause death ratio.ConclusionThis study provides the cumulative risk of SD (1 in 1694 newborns) by age 14 years. The time trend underlines the effect of medical advance and education on SD prevention. Distinct regional/ethnic differences in risks of SD and all-cause death in Taiwan and the US indicate the necessity of different strategies to diminish the disparity.Copyright © 2020 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

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