US medical examiners and coroners lack a uniform method to investigate and classify sudden unexpected infant deaths (SUID), leading them to certify the same deaths differently, according to a study published in the July 2017 issue of Pediatrics.

The study, “Variation in Cause-of-Death Determination for Sudden Unexpected Infant Deaths” (published online June 5), posed hypothetical scenarios of infant deaths in a survey mailed to 801 medical examiners and coroners from January to November, 2014.

Of the responses, 377 surveys were deemed eligible and complete. Given 4 different SUID case scenarios, the medical examiners and coroners did not universally agree on how to classify the deaths and did not universally use the term SIDS (sudden infant death syndrome) to classify unexplained infant deaths. The study also indicated that the certifiers did not consider the same types of evidence to classify deaths as suffocation, overlay, wedging, and neck compression or hanging.

The authors concluded that variability in cause-of-death determination practices influences how SUID are reported and classified, which negatively impacts research into the causes of infant mortality, and the ability to monitor and potentially prevent future deaths effectively. They encourage promoting standardized practices in the field, especially concerning SUID.