Spatial analysis of sleep-related infant deaths in Argentina (1997-2019)

Abstract

Objective: Our objective was to analyze the spatial and temporal variation of sleep-related infant deaths (SID) and its causes in Argentina between 1997-2019. Differences in the prevalence of supine posiotioning and other sleeep envorinment conditions among different ethnic populations may contribute to these multidimensional disparities.MethodsData on SID were obtained from the Ministry of Health of Argentina. The rate of SID (SIDR) and the porcentages of causes of deaths (R95, R96, R99, W75, W78, W79, classified according to ICD-10 diagnosis codes) were calculated geographically at the level of regions based on enviromental similarities: North-West (NWA), North-East (NEA), Cuyo, Centre and Patagonia. Moran Index and Local Indicators of Spatial Association (LISA) were used to describe temporal and spatial variation.Ethics approvalThis study follows the bioethical guidelines proposed by the Argentinean Ministry of Health (2011), wich exempt epidemiological studies that use public or publicly available records of information from obtaining informed consent.ResultsThere is a negative secular trend in SIDR, wich is more pronounced and significant in the more developed regions of the country. The SIDR by triennium and regios are highest in all the country at the beginning of the time series and during the first fifteen years, followed by a progressive ans consistent reduction. However, it continues to rise persistently in Cuyo, NWA, NEA and Centre.ConclusionsThe investigation study preented threee main areas: 1) Addressing the potential impact of structural racism; 2) Recognizing the lack of access to economic, social, and educational resources as a risk factor for sleep-related infant deaths; 3) It is essential to create a SID National Registry standarizing data collection throughout the territory. In this way, the federal registry would allow real-time knowledge of the factors that contribute to the risk of SID and optimize preventive recommendations taking into account the georeferencing of cases to know the areas in wich actions should be focused and effort concentrated.