Study in PEDIATRICS: Racial and Ethnic Trends in Sudden Unexpected Infant Deaths

From article commentary by Richard D. Goldstein and Hannah C. Kinney:

In this important research, the authors provide further evidence that we may be complacent when we treat SIDS/SUID as a tragic mishap due only to risk in the sleep environment and tend to ignore the possibility that it is the consequence of biological vulnerabilities in at least some of these infants. The elimination of any disparities and ultimately the elimination of SIDS is the goal. This may require increased efforts at biomedical discovery in addition to more effective messaging about reducing risk factors. “Racial and Ethnic Trends in Sudden Unexpected Infant Deaths: United States, 1995–2013” provides important reasons to examine our premises

Article reference: Parks SE, Erck Lambert AB, Shapiro-Mendoza CK. Racial and Ethnic Trends in Sudden Unexpected Infant Deaths: United States, 1995–2013. Pediatrics. 2017; 139(6):e20163844


BACKGROUND AND OBJECTIVES: Immediately after the 1994 Back-to-Sleep campaign, sudden unexpected infant death (SUID) rates decreased dramatically, but they have remained relatively stable (93.4 per 100 000 live births) since 2000. In this study, we examined trends in SUID rates and disparities by race/ethnicity since the Back-to-Sleep campaign.

METHODS: We used 1995–2013 US period-linked birth-infant death data to evaluate SUID rates per 100 000 live births by non-Hispanic white (NHW), non-Hispanic black (NHB), Hispanic, American Indian/Alaska Native, and Asian/Pacific Islander racial/ethnic groupings. To examine racial/ethnic disparities, we calculated rate ratios with NHWs as the referent group. Unadjusted linear regression was used to evaluate trends (P < .05) in rates and rate ratios. The distribution and rates of SUID by demographic and birth characteristics were compared for 1995–1997 and 2011–2013, and χ2 tests were used to evaluate significance.

RESULTS: From 1995 to 2013, SUID rates were consistently highest for American Indian/Alaska Natives, followed by NHBs. The rate for NHBs decreased significantly, whereas the rate for NHWs also declined, but not significantly. As a result, the disparity between NHWs and NHBs narrowed slightly. The SUID rates for Hispanics and Asian/Pacific Islanders were lower than the rates for NHWs and showed a significant decrease, resulting in an increase in their advantage over NHWs.

CONCLUSIONS: Each racial/ethnic group showed a unique trend in SUID rates since the Back-to-Sleep campaign. When implementing risk-reduction strategies, it is important to consider these trends in targeting populations for prevention and developing culturally appropriate approaches for racial/ethnic communities.