Working with numbers: New app hopes to improve infant mortality rates

Maths may prove to be the answer to sudden unexpected death in infants (SUDI) which is responsible for the death of 50 babies every year. Professor Ed Mitchell, from the University of Auckland, has received $200,000 of funding from Cure Kids and Perpetual Guardian allowing him to trial his Safe Sleep Calculator (SSC) which identifies a baby’s risk of SUDI.

Professor Mitchell led a study in the late 80s and found a vast majority of sudden unexpected death in infants (SUDI) deaths are preventable. He identified a number of contributing factors including sleep positioning, babies sharing the parental bed and smoking which led to a decline in New Zealand’s mortality rate from 250 a year to 50 a year.

Now, after working to understand the interplay between the risk factors, Professor Mitchell hopes his SSC will improve the SUDI mortality rate further.

The SSC is an app which is able to assign families with a rating based on the risk factors relevant to them. Data can be entered into an equation, developed by Professor Bob Carpenter a statistician in the UK, relating to the factors which will identify the baby’s chance of dying and identify it as a high or low risk.

Now, with funding, the SCC is being trialed in a number of general practices which Mitchell says will assess how well it is accepted by families and the GPs and whether anything need to be modified.

One of these practices is Dr Christine McIntosh’s in Howick. While Professor Mitchell says the families who attend the practice are generally low risk, the mothers are happy to receive feedback that they are doing all the right things. However for those who are identified as high risk, Professor Mitchell hopes the SSC will act as an educational tool as well as a calculator.

“We don’t want to just finger point and say you are a high risk mother. We want to make this a positive experience and provide guidance to the GPs on what they should be targeting and making it positive to the parents rather than just saying you are high risk so be careful.”

He says telling a mother their baby is at high risk and has a one in 50 chance of dying doesn’t mean much. Instead it’s hoped the mother can learn about what can be done to reduce that risk. “For example, we know lying babies on their tummy increases the risk. So if a mother puts her baby to sleep on its tummy we can say, ‘If you lay your baby on its back then this risk goes down to this level’, so you can play this ‘what if?’ game.”

Professor Mitchell wants to see the SSC implemented across all general practices to be used when babies receive their six week immunisations. He says this provides time for a full check up and for the GP to provide guidance according to the identified risk.

While the SSC is the first equation to improve infant health, it is not the first time equations have been used to identify risk factors in patients. Professor Rod Jackson, also from the University of Auckland, developed a ‘Predict’ programme which identifies the cardiovascular risk of patients to determine their risk of a stroke or a heart attack in the next five years.