RT Journal Article SR Electronic T1 Ethnic variation in unexplained deaths in infancy, including sudden infant death syndrome (SIDS), England and Wales 2006–2012: national birth cohort study using routine data JF Journal of Epidemiology and Community Health JO J Epidemiol Community Health FD BMJ Publishing Group Ltd SP 911 OP 918 DO 10.1136/jech-2018-210453 VO 72 IS 10 A1 Mary E Kroll A1 Maria A Quigley A1 Jennifer J Kurinczuk A1 Nirupa Dattani A1 Yangmei Li A1 Jennifer Hollowell YR 2018 UL http://jech.bmj.com/content/72/10/911.abstract AB Background Unexplained deaths in infancy comprise ‘sudden infant death syndrome’ (SIDS) and deaths without ascertained cause. They are typically sleep-related, perhaps triggered by unsafe sleep environments. Preterm birth may increase risk, and varies with ethnicity. We aimed to compare ethnic-specific rates of unexplained infant death, explore sociodemographic explanations for ethnic variation, and examine the role of preterm birth.Methods We analysed routine data for 4.6 million live singleton births in England and Wales 2006–2012, including seven non-White ethnic groups ranging in size from 29 313 (Mixed Black-African-White) to 180 265 (Pakistani). We calculated rates, birth-year-adjusted ORs, and effects of further adjustments on the χ2 for ethnic variation.Results There were 1559 unexplained infant deaths. Crude rates per 1000 live singleton births were as follows: 0.1–0.2 for Indian, Bangladeshi, Pakistani, White Non-British, Black African; 0.4 for White British; 0.6–0.7 for Mixed Black-African-White, Mixed Black-Caribbean-White, Black Caribbean. Birth-year-adjusted ORs relative to White British ranged from 0.38 (95% CI 0.24 to 0.60) for Indian babies to 1.73 (1.21 to 2.47) for Black Caribbean (χ2(10 df)=113.6, p<0.0005). Combined adjustment for parents’ marital/registration status and mother’s country of birth (UK/non-UK) attenuated the ethnic variation. Adjustments for gestational age at birth, maternal age and area deprivation made little difference.Conclusion Substantial ethnic disparity in risk of unexplained infant death exists in England and Wales. Apparently not attributable to preterm birth or area deprivation, this may reflect cultural differences in infant care. Further research into infant-care practices in low-risk ethnic groups might enable more effective prevention of such deaths in the general population.