SIDS is a diagnosis of exclusion where the cause of death remains unexplained after a thorough investigation, including a complete autopsy, examination of the death scene, and review of clinical history [11]. This is likely an underestimate since the early neonatal deaths occurring out of territory were not available for review. Feb 12, 2016 In 2012, the average Nunavut mother was about age 25 at time of delivery, says StatsCan Nunavut remains the territory with the highest infant mortality and the youngest mothers, according to 2012 data released by Statistics Canada this week. Statistics Canada: Table 051–0053 - Components of population growth by census division, sex and age group for the period from July 1 to June 30, based on the Standard Geographical Classification (SGC) 2006, annual (persons), CANSIM (database). An estimated 850 infants are born in Nunavut each year, with 90-95% of those being born to Inuit women [2, 5]. Sleep environment was obtained from death scene investigation report. 524 0 obj <>stream 0000071724 00000 n The infant mortality rate in Nunavut is 3 times the national average, and twice that of the neighbouring territory, the Northwest Territories. Bonnefont J-P, Demaugre F, Prip-Buus C, Saudubray JM, Brivet M, Abadi N, Thuillier L: Carnitine palmitoyltransferase deficiencies. Information regarding sleep position needs to be better communicated in a culturally appropriate manner. 10.1258/0004563041201473. The infant mortality rate in Nunavut is 3 times the national average, and twice that of the neighbouring territory, the Northwest Territories. Muggah E, Way D, Muirhead M, Baskerville B: Preterm delivery among Inuit women in the Baffin Region of the Canadian Arctic. 1999, 68: 424-440. The ‘triple risk hypothesis’ for SIDS proposes that an external stressor combines with an underlying vulnerability at a critical development period to cause a SIDS death [47]. Pediatr Pathol. The P479L (c.1436C>T) genetic variant of the hepatic fatty acid oxidation enzyme, carnitine palmitoyltransferase 1A (CPT1A), has been associated with infant mortality in Alaska Native and British Columbia coastal First Nations populations, where the variant is common [22, 23]. U�F�����%8r�<23S�mU#��:Ю! 0000145479 00000 n 10.1194/jlr.P900001-JLR200. Although underpowered, the association of P479L homozygosity with unexpected infant death was less apparent in the high prevalence regions, especially in the Kitikmeot region (OR: 1.09, 95% CI: 0.19-11.47), which had the highest rates of postneonatal mortality, SIDS/SUDI and infant death due to infection. Northern Canada. Cases were grouped into one of four major cause of death categories; SIDS/SUDI, infection (respiratory, H influenza or other), congenital anomaly or other. 0000070072 00000 n 0000146660 00000 n The infant mortality rate in Nunavut is 3 times the national average, and twice that of the neighbouring territory, the Northwest Territories. The northern territory Nunavut has Canada’s largest jurisdictional land mass with 33,322 inhabitants, of which 85% self-identify as Inuit. 1 The infant mortality rate 2.3 per 1,000 for In uit infants in Canada. BMC Pediatrics N Engl J Med. The significantly lower P479L homozygosity in the Qikiqtani region may be due to admixture and/or a higher rate of non-Inuit immigration from other regions and provinces. 0000074773 00000 n Population stratification as an underlying determinant of this association needs further assessment, as does the association of other potentially interactive risk factors. Clin Chem. Although our data are limited, our results are consistent with other studies that suggest bed-sharing with additional risk factors present increases risk for SIDS/SUDI [18, 19]. © 2021 BioMed Central Ltd unless otherwise stated. Two-tailed p values <0.05 were considered significant. 0000003772 00000 n In this review, Nunavut rates of SIDS/SUDI (6.08/1,000) and infection (2.71/1,000) were significantly higher than national rates (2003–2007) and consistent with those previously reported for Inuit-inhabited regions of Canada (1990–2000) [10]. In 2004, the Manitoba Newborn Screening program commenced a pilot CPT1A P479L newborn screening program for infants born to Kivalliq region residents [30]. Rates were compared to published data for Canada. Nunavut's infant mortality rate was calculated as 21.4 per 1,000 live births. Nunavut’s infant mortality rate is nearly five times higher than the national average. It remains controversial whether the variant is a risk factor itself for infant mortality or a marker of other population-based risk factors more common in high prevalence areas. 10.1016/S0140-6736(07)61662-6. Kovesi T, Creery D, Gilbert NL, Dales R, Fugler D, Thompson B, Randhawa N, Miller JD: Indoor air quality risk factors for severe lower respiratory tract infections in Inuit infants in Baffin Region, Nunavut: a pilot study. 0000073665 00000 n Cause specific mortality rates for SIDS/SUDI and respiratory infections were higher in the Kitikmeot region than in the Kivalliq and Qikiqtani regions. Finland’s infant mortality rate was 90 in 1,000 live births, and has seen a dramatic drop to less than two in 1,000 births due to its famous Finnish Maternity Package (baby boxes). 2007, 161: 237-245. Ann Clin Biochem. In fact, Nunavut’s three-year average rate of 18.5 deaths per 1,000 live births is much higher than second-to-last-place N.W.T.’s average infant mortality rate of 8. Nunavut, a northern Canadian territory covering the most northern and eastern area of Canada, is Canada’s largest jurisdictional land mass with 33,322 inhabitants, of which 85% self-identify as Inuit [1, 2]. Ninety infant deaths occurred in Nunavut and were reported to the Chief Coroner. Although the P479L variant was associated with unexpected infant death in Nunavut as a whole, the association was less apparent when population stratification was considered. Nunavut's infant mortality rate was calculated as 21.4 per 1,000 live births. Infant mortality is strongly associated with socioeconomic status in Canada: Infant mortality rate by income Footnote * By income Rate per 1 000 live births (birth weight 500+ g) Lowest income: 4.7 : https://doi.org/10.1186/1471-2431-12-190, DOI: https://doi.org/10.1186/1471-2431-12-190. High levels of prenatal exposure to cigarette smoke increases the risk of premature birth [41, 43]. Canada can do much better. 2007, 151: 450-456.e1. Gestational age at birth was available for 41 cases, 14 (25%) were born premature (<37 completed weeks of gestation). 2005, 64: 38-45. 0000082231 00000 n ʗy��A��r�"�h���e%6����~\��y8j��%l``tj� П}P�c-�S����: &8�9v�KK�w u��R��Q\����dԴ�ȄjP/�@��fAݮ�3ף�8ء���,�dHaf�#�c>FYa�(;`hs8���,���!x F:�/y��V���ƻ �@#������E�ڲ�S}mn-��m���*BB�*tB/�����W�ʻ͠XQѶ4��LK/2Q3�(��i�0O�^��JÄ�BOa�1D! 2012, Ottawa, [http://www.phac-aspc.gc.ca/rhs-ssg/phi-isp-2011-eng.php]. Information on maternal and household characteristics, including parity, maternal age, maternal education, household income and food security, were very limited or not available for this review. 0000081545 00000 n 0000074853 00000 n Google Scholar. The majority of deaths were due to respiratory infection (n=15) or Haemophilus influenzae infection (type a or b; n=6). Infant mortality rate 4 times higher . 2010, 101: 200-204. Therefore it is expected that the neonatal mortality rate is lower in our study than reported elsewhere [3, 10]. Dark purple tones indicate regions with high infant mortality rates and correspondingly light purple tones indicate regions with low infant mortality rate. Sudden Unexpected Death in Infancy (SUDI) is a broader category that includes unexpected infants deaths with other risk factors present, such as an illness or risk factors for asphyxia [12, 13]. during fasting or prolonged exercise). hެRmL�W>�--}mi( P��)m�s-D"J�W��� �1���(. Nunavut has rates of infant mortality, postneonatal mortality and hospitalisation of infants for respiratory infections that greatly exceed those for the rest of Canada. Boles RG, Buck EA, Blitzer MG, Platt MS, Cowan TM, Martin SK, Yoon H, Madsen JA, Reyes-Mugica M, Rinaldo P: Retrospective biochemical screening of fatty acid oxidation disorders in postmortem livers of 418 cases of sudden death in the first year of life. Q�D@Z@'f�P؜sa���#|h��-R�M �`3�ȶۗ From 2009–2010, there were 11 cases under age 2 confirmed in Nunavut (G Osborne, personal communication). Rajakumar C, Ban MR, Cao H, Young TK, Bjerregaard P, Hegele RA: Carnitine palmitoyltransferase IA polymorphism P479L is common in Greenland Inuit and is associated with elevated plasma apolipoprotein A-I. 1991, 11: 677-684. While the infant mortality rate in Canada has improved over the past few decades, this improvement is not equally distributed. The causes of SIDS and SUDI are multi-factorial, due to a combination of environmental, developmental and genetic factors [12–15]. 0000070625 00000 n 10.1503/cmaj.091297. 10.1016/j.jpeds.2007.05.002. prevalenceofcarnitinepalmitoyltransferase1a(cpt1a)vari ant p.p479l)and)riskof)infant)mortality)in)nunavut,northwest territories,and)yukon) by!!! 0000075238 00000 n 0000146839 00000 n Due to limited information, risk associated with sleep practices could not be analysed. 0000069705 00000 n Part of SIDS and deaths due to infections have been previously identified as the leading contributors to the higher rates of postneonatal mortality in indigenous populations of Western Australia and Alaska [33, 34]. Int J Circumpolar Health. Messaging about infant care and sleep practices should come from within communities as well as from health care providers. Ethics and regulatory approval was obtained from UBC Research Ethics Board, Nunavut Research Institute and University of Manitoba Research Ethics Board. volume 12, Article number: 190 (2012) The International Circumpolar Surveillance system reports that northern Canada has the highest rate of invasive Haemophilus influenzae type A in children under the age of two in the circumpolar region (1999–2006) [40]. Bed-sharing was also prevalent in SIDS/SUDI cases (70% of those with bed-sharing information); however, a majority of cases bed-sharing at time of death had additional sleep-related risk factors present, including non-supine sleep position and/or bed-sharing with non-caregiver(s). Privacy 0000103226 00000 n Nunavut’s infant mortality rate is nearly five times higher than the national average. 2004, 63 (Suppl 2): 80-85. 10.1001/archpedi.161.3.237. Carnitine palmitoyltransferase 1 deficiency, http://www5.statcan.gc.ca/cansim/a26?lang=eng&retrLang=eng&id=0510001&paSer=&pattern=&stByVal=1&p1=1&p2=-1&tabMode=dataTable&csid=, http://www12.statcan.ca/census-recensement/2006/as-sa/97-558/index-eng.cfm?CFID=78991&CFTOKEN=71134813, http://www5.statcan.gc.ca/cansim/a26?lang=eng&retrLang=eng&id=1020507&paSer=&pattern=&stByVal=1&p1=1&p2=-1&tabMode=dataTable&csid=, http://www5.statcan.gc.ca/cansim/a26?lang=eng&retrLang=eng&id=1024304&paSer=&pattern=&stByVal=1&p1=1&p2=-1&tabMode=dataTable&csid=, http://www5.statcan.gc.ca/cansim/a26?lang=eng&retrLang=eng&id=1024501&paSer=&pattern=&stByVal=1&p1=1&p2=-1&tabMode=dataTable&csid=, http://www.phac-aspc.gc.ca/rhs-ssg/survey-eng.php, http://www5.statcan.gc.ca/cansim/a26?lang=eng&retrLang=eng&id=0510054&paSer=&pattern=&stByVal=1&p1=1&p2=-1&tabMode=dataTable&csid=, http://www.phac-aspc.gc.ca/rhs-ssg/phi-isp-2011-eng.php, http://www5.statcan.gc.ca/cansim/a26?lang=eng&retrLang=eng&id=1024512&paSer=&pattern=&stByVal=1&p1=1&p2=-1&tabMode=dataTable&csid=, http://www.phac-aspc.gc.ca/publicat/2008/cphr-rspc/index-eng.php, http://www5.statcan.gc.ca/cansim/a26?lang=eng&retrLang=eng&id=0510053&paSer=&pattern=&stByVal=1&p1=1&p2=-1&tabMode=dataTable&csid=, http://www.biomedcentral.com/1471-2431/12/190/prepub. [email protected] n_���{�Лl��Ķ���l��V�`Wp� �'�7�ׯ�{ف&���m�`�d�v[���K�|Ѽ�@nH€(�Q�� 0000070797 00000 n Lauson S, McIntosh S, Obed N, Healey G, Asuri S, Osborne G, Arbour L: The development of a comprehensive maternal child health surveillance system for Nunavut-Nutaqqavut (Our Children). Department of Medical Genetics, University of British Columbia Island Medical Program, University of Victoria, PO Box 1700 STN CSC, Victoria, BC, V8W 2Y2, Canada, Court Services Division, Department of Justice, Government of Nunavut, Iqaluit, NU, Canada, Department of Health and Social Services, Government of Nunavut, Iqaluit, NU, Canada, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada, Nunavut Tunngavik Incorporated, Iqaluit, NU, Canada, Laakkuluk Williamson Bathory & Sharon Edmunds-Potvin, You can also search for this author in Necessarily reflect the official position of nunavut infant mortality rate Canada: 8.92-15.79 ) equally distributed play a role in these.! 35 cases with genotype, sleep position, sleep position needs to born! Small numbers 3 times the national average, and twice that of the multiple factors! Developmental and genetic factors [ 12–15 ] on request of the 35 cases with genotype 30! 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