Sudden infant death syndrome (SIDS) is the most common cause of death for infants between 1 month and 1 year of age in the United States. The objective was to examine recent trends in SIDS in the United States, over time and by sex and race. A population-based cross-sectional study was conducted on 80 710 348 live births using data from the Center for Disease Control and Prevention’s (CDC) “Birth Data” and “Mortality Multiple Cause” files from 2000 to 2019. Logistic regression examined the effects of sex and race on the risk of SIDS and examined temporal changes in risk across sex and race over the study period. Incidence of SIDS decreased from 6.3 to 3.4/10 000 births from 2000 to 2019, with an overall incidence of 4.9/10 000 births (95% confidence interval [CI] = 4.4-5.3). Male infants were at the greatest risk of SIDS as were black and American Indian infants. Although SIDS incidence decreased by sex and race over time, the decline was smaller among Hispanic and American Indian infants.
WillingerMJamesLSCatzC.Defining the sudden infant death syndrome (SIDS): deliberations of an expert panel convened by the National Institute of Child Health and Human Development. Pediatr Pathol. 1991;11(5):677-684. doi:10.3109/15513819109065465.
2.
KrousHF.Sudden infant death syndrome: pathology and pathophysiology. Pathol Annu. 1984;19(19, pt 1):1-14.
3.
Moon RY; Task Force on Sudden Infant Death Syndrome. SIDS and other sleep-related infant deaths: evidence base for 2016 updated recommendations for a safe infant sleeping environment. Pediatrics. 2016;138(5):e20162940. doi:10.1542/peds.2016-2940.
4.
ChangRKKeensTGRodriguezSChenAY.Sudden infant death syndrome: changing epidemiologic patterns in California 1989-2004. J Pediatr. 2008;153(4):498-502. doi:10.1016/j.jpeds.2008.04.022.
5.
RichardsonHLWalkerAMHorneRS.Sleeping like a baby—does gender influence infant arousability?Sleep. 2010;33(8):1055-1060. doi:10.1093/sleep/33.8.1055.
6.
MatobaNCollinsJWJr.Racial disparity in infant mortality. Semin Perinatol. 2017;41(6):354-359. doi:10.1053/j.semperi.2017.07.003.
7.
Canadian Institutes of Health Research, Natural Sciences and Engineering Research Council of Canada, and Social Sciences and Humanities Research Council. Tri-council policy statement: ethical conduct for research involving humans. Published 2018. Accessed November 25, 2023. https://ethics.gc.ca/eng/documents/tcps2-2018-en-interactive-final.pdf.
8.
CamperlengoLTShapiro-MendozaCKKimSY.Sudden infant death syndrome: diagnostic practices and investigative policies, 2004. Am J Forensic Med Pathol. 2012;33(3):197-201. doi:10.1097/PAF.0b013e3181fe33bd.
9.
Shapiro-MendozaCKTomashekKMAndersonRNWingoJ.Recent national trends in sudden, unexpected infant deaths: more evidence supporting a change in classification or reporting. Am J Epidemiol. 2006;163(8):762-769. doi:10.1093/aje/kwj117.
10.
GoldsteinRDBlairPSSensMA, et al. Inconsistent classification of unexplained sudden deaths in infants and children hinders surveillance, prevention and research: recommendations from the 3rd International Congress on Sudden Infant and Child Death. Forensic Sci Med Pathol. 2019;15(4):622-628. doi:10.1007/s12024-019-00156-9.
11.
MiniñoAMXuJKochanekKD.Deaths: preliminary data for 2008. Natl Vital Stat Rep. 2010;59(2):1-52.
12.
DwyerTPonsonbyALBlizzardLNewmanNMCochraneJA.The contribution of changes in the prevalence of prone sleeping position to the decline in sudden infant death syndrome in Tasmania. JAMA. 1995;273(10):783-789.
13.
HuntCEHauckFR.Sudden infant death syndrome. CMAJ. 2006;174(13):1861-1869. doi:10.1503/cmaj.051671.
14.
TrachtenbergFLHaasEAKinneyHCStanleyCKrousHF.Risk factor changes for sudden infant death syndrome after initiation of Back-to-Sleep campaign. Pediatrics. 2012;129(4):630-638. doi:10.1542/peds.2011-1419.
15.
HakeemGFOddyLHolcroftCAAbenhaimHA.Incidence and determinants of sudden infant death syndrome: a population-based study on 37 million births. World J Pediatr. 2015;11(1):41-47. doi:10.1007/s12519-014-0530-9.
16.
ZhangKWangX.Maternal smoking and increased risk of sudden infant death syndrome: a meta-analysis. Leg Med (Tokyo). 2013;15(3):115-121. doi:10.1016/j.legalmed.2012.10.007.
17.
de LucaFHindeA. Effectiveness of the “Back-to-Sleep” campaigns among healthcare professionals in the past 20 years: a systematic review. BMJ Open. 2016;6(9):e011435. doi:10.1136/bmjopen-2016-011435.
18.
MoscovisSMHallSTBurnsCJScottRJBlackwellCC.The male excess in sudden infant deaths. Innate Immun. 2014;20(1):24-29. doi:10.1177/1753425913481071.
19.
MitchellEAStewartAW.Gender and the sudden infant death syndrome. New Zealand Cot Death Study Group. Acta Paediatr. 1997;86(8):854-856. doi:10.1111/j.1651-2227.1997.tb08611.x.
20.
CornwellAC.Sex differences in the maturation of sleep/wake patterns in high risk for SIDS infants. Neuropediatrics. 1993;24(1):8-14. doi:10.1055/s-2008-1071505.
21.
de JongeGABurgmeijerRJEngelbertsACHoogenboezemJKostensePJSprijAJ.Sleeping position for infants and cot death in the Netherlands 1985-91. Arch Dis Child. 1993;69(6):660-663. doi:10.1136/adc.69.6.660.
22.
GobermanAMJohnsonSCannizzaroMSRobbMP.The effect of positioning on infant cries: implications for sudden infant death syndrome. Int J Pediatr Otorhinolaryngol. 2008;72(2):153-165. doi:10.1016/j.ijporl.2007.09.019.
23.
StifflerDAyresBFauvergueCCullenD.Sudden infant death and sleep practices in the Black community. J Spec Pediatr Nurs. 2018;23(2):e12213. doi:10.1111/jspn.12213.
24.
WomackLSRossenLMHiraiAH.Urban-rural infant mortality disparities by race and ethnicity and cause of death. Am J Prev Med. 2020;58(2):254-260. doi:10.1016/j.amepre.2019.09.010.
25.
ElyDMDriscollAK.Infant Mortality in the United States, 2021: Data From the Period Linked Birth/Infant Death File (National vital statistics reports, Vol. 72, No. 11). Hyattsville, MD: National Center for Health Statistics; 2023. doi:10.15620/cdc:131356.
26.
LiuCMChangSDChengPJ.Relationship between prenatal care and maternal complications in women with preeclampsia: implications for continuity and discontinuity of prenatal care. Taiwan J Obstet Gynecol. 2012;51(4):576-582. doi:10.1016/j.tjog.2012.09.013.
27.
SmylieJFellDBChalmersB, et al. Socioeconomic position and factors associated with use of a nonsupine infant sleep position: findings from the Canadian Maternity Experiences Survey. Am J Public Health. 2014;104(3):539-547. doi:10.2105/ajph.2012.301061.
28.
Al HadidiSDongarwarDSalihuHM, et al. Health disparities experienced by Black and Hispanic Americans with multiple myeloma in the United States: a population-based study. Leuk Lymphoma. 2021;62(13):3256-3263. doi:10.1080/10428194.2021.1953013.
29.
SmithMGLiuJHHelmsKHWilkersonKL.Racial differences in trends and predictors of infant sleep positioning in South Carolina, 1996-2007. Matern Child Health J. 2012;16(1):72-82. doi:10.1007/s10995-010-0718-0.
30.
ColsonERWillingerMRybinD, et al. Trends and factors associated with infant bed sharing, 1993-2010: the National Infant Sleep Position Study. JAMA Pediatr. 2013;167(11):1032-1037. doi:10.1001/jamapediatrics.2013.2560.
31.
HauckFRHermanSMDonovanM, et al. Sleep environment and the risk of sudden infant death syndrome in an urban population: the Chicago Infant Mortality Study. Pediatrics. 2003;111(5, pt 2):1207-1214.
32.
WongCAGachupinFCHolmanRC, et al. American Indian and Alaska Native infant and pediatric mortality, United States, 1999-2009. Am J Public Health. 2014;104(suppl 3):S320-S328. doi:10.2105/ajph.2013.301598.
33.
IrwinKLManninoSDalingJ.Sudden infant death syndrome in Washington State: why are Native American infants at greater risk than white infants?J Pediatr. 1992;121(2):242-247. doi:10.1016/s0022-3476(05)81195-3.
34.
IyasuSRandallLLWeltyTK, et al. Risk factors for sudden infant death syndrome among northern plains Indians. JAMA. 2002;288(21):2717-2723. doi:10.1001/jama.288.21.2717.
35.
BulterysM.High incidence of sudden infant death syndrome among northern Indians and Alaska natives compared with southwestern Indians: possible role of smoking. J Community Health. 1990;15(3):185-194. doi:10.1007/bf01350256.
36.
CastorMLSmyserMSTaualiiMMParkANLawsonSAForqueraRA.A nationwide population-based study identifying health disparities between American Indians/Alaska Natives and the general populations living in select urban counties. Am J Public Health. 2006;96(8):1478-1484. doi:10.2105/ajph.2004.053942.
37.
MalloyMH.Sudden infant death syndrome among extremely preterm infants: United States 1997-1999. J Perinatol. 2004;24(3):181-187. doi:10.1038/sj.jp.7211051.
38.
O’LearyCMJacobyPJBartuAD’AntoineHBowerC.Maternal alcohol use and sudden infant death syndrome and infant mortality excluding SIDS. Pediatrics. 2013;131(3):e770-e778. doi:10.1542/peds.2012-1907.
39.
LahrMBRosenbergKDLapidusJA.Maternal-infant bedsharing: risk factors for bedsharing in a population-based survey of new mothers and implications for SIDS risk reduction. Matern Child Health J. 2007;11(3):277-286. doi:10.1007/s10995-006-0166-z.
40.
MoonRYHauckFRColsonER.Safe infant sleep interventions: what is the evidence for successful behavior change?Curr Pediatr Rev. 2016;12(1):67-75. doi:10.2174/1573396311666151026110148.
41.
BallHLMoyaEFairleyLWestmanJOddieSWrightJ.Infant care practices related to sudden infant death syndrome in South Asian and White British families in the UK. Paediatr Perinat Epidemiol. 2012;26(1):3-12. doi:10.1111/j.1365-3016.2011.01217.x.
42.
MathewsAAJoynerBLOdenRPAlamoIMoonRY.Comparison of infant sleep practices in African-American and US Hispanic Families: implications for sleep-related infant death. J Immigr Minor Health. 2015;17(3):834-842. doi:10.1007/s10903-014-0016-9.
43.
BroussardDLSappenfieldWMGoodmanDA.The Black and White of infant back sleeping and infant bed sharing in Florida, 2004-2005. Matern Child Health J. 2012;16(3):713-724. doi:10.1007/s10995-011-0768-y.
44.
OttoliniMCDavisBEPatelKSachsHCGershonNBMoonRY.Prone infant sleeping despite the “Back to Sleep” campaign. Arch Pediatr Adolesc Med. 1999;153(5):512-517. doi:10.1001/archpedi.153.5.512.
45.
Shapiro-MendozaCKKimSYChuSYKahnEAndersonRN.Using death certificates to characterize sudden infant death syndrome (SIDS): opportunities and limitations. J Pediatr. 2010;156(1):38-43. doi:10.1016/j.jpeds.2009.07.017.
46.
AndersonRNMiniñoAMHoyertDLRosenbergHM.Comparability of cause of death between ICD-9 and ICD-10: preliminary estimates. Natl Vital Stat Rep. 2001;49(2):1-32.
