Altitude and risk of sudden unexpected infant death in the United States

AbstractThe effect of altitude on the risk of sudden infant death syndrome (SIDS) has been reported previously, but with conflicting findings. We aimed to examine whether the risk of sudden unexpected infant death (SUID) varies with altitude in the United States. Data from the Centers for Disease Control and Prevention (CDC)’s Cohort Linked Birth/Infant Death Data Set for births between 2005 and 2010 were examined. County of birth was used to estimate altitude. Logistic regression and Generalized Additive Model (GAM) were used, adjusting for year, mother’s race, Hispanic origin, marital status, age, education and smoking, father’s age and race, number of prenatal visits, plurality, live birth order, and infant’s sex, birthweight and gestation. There were 25,305,778 live births over the 6-year study period. The total number of deaths from SUID in this period were 23,673 (rate = 0.94/1000 live births). In the logistic regression model there was a small, but statistically significant, increased risk of SUID associated with birth at > 8000 feet compared with < 6000 feet (aOR = 1.93; 95% CI 1.00–3.71). The GAM showed a similar increased risk over 8000 feet, but this was not statistically significant. Only 9245 (0.037%) of mothers gave birth at > 8000 feet during the study period and 10 deaths (0.042%) were attributed to SUID. The number of SUID deaths at this altitude in the United States is very small (10 deaths in 6 years).

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Incidence of Recurrence of Sudden Infant Death Syndrome

Pediatrics in Review ◽

10.1542/pir.14.3.94 ◽

1993 ◽

Vol 14 (3) ◽

pp. 94-116

Keyword(s):

United States ◽

Sudden Infant Death Syndrome ◽

Infant Death ◽

South Australia ◽

Sudden Infant Death ◽

The United States ◽

Sudden Infant ◽

Specific Population ◽

Live Births ◽

Increased Risk

Incidence figures for sudden infant death syndrome (SIDS) are affected by the specific population being studied, the method of data collection, the way in which the diagnosis is determined, and other variables. The occurrence of SIDS per 100 live births has been estimated to be 1.3 in Norway, 2.1 in South Australia, and 2 to 3 in the United States. Subsequent siblings are at increased risk of SIDS, with estimates ranging from 3.7 times that of the general population to as high as 10 times. Beal et al found that families in South Australia who lost a child older than 12 months of age to SIDS were 11 times more likely to have a subsequent child with SIDS than were families in which the SIDS victim was younger than 1 year of age.

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Testing for Infectious Diseases in Sudden Unexpected Infant Death: A Survey of Medical Examiner and Coroner Offices in the United States

The Journal of Pediatrics ◽

10.1016/j.jpeds.2015.04.007 ◽

2015 ◽

Vol 167 (1) ◽

pp. 178-182.e1 ◽

Cited By ~ 10

Author(s):

Erin G. Brooks ◽

James R. Gill ◽

Robert Buchsbaum ◽

Suzanne Utley ◽

Lakshmanan Sathyavagiswaran ◽

...

Keyword(s):

United States ◽

Infectious Diseases ◽

Infant Death ◽

The United States ◽

Medical Examiner ◽

Sudden Unexpected Infant Death ◽

Unexpected Infant Death

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Geographic Variation in Sudden Unexpected Infant Death in the United States

The Journal of Pediatrics ◽

10.1016/j.jpeds.2020.01.006 ◽

2020 ◽

Vol 220 ◽

pp. 49-55.e2 ◽

Cited By ~ 1

Author(s):

Edwin A. Mitchell ◽

Xiaohan Yan ◽

Shirley You Ren ◽

Tatiana M. Anderson ◽

Jan-Marino Ramirez ◽

...

Keyword(s):

United States ◽

Geographic Variation ◽

Infant Death ◽

The United States ◽

Sudden Unexpected Infant Death ◽

Unexpected Infant Death

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Circadian variation in sudden unexpected infant death in the United States

Acta Paediatrica ◽

10.1111/apa.15695 ◽

2020 ◽

Author(s):

Tatiana M. Anderson ◽

Kelty Allen ◽

Jan‐Marino Ramirez ◽

Edwin A. Mitchell

Keyword(s):

United States ◽

Infant Death ◽

Circadian Variation ◽

The United States ◽

Sudden Unexpected Infant Death ◽

Unexpected Infant Death

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State-level trends in sudden unexpected infant death and immunization in the United States: an ecological study

BMC Pediatrics ◽

10.1186/s12887-021-02733-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jacqueline Müller-Nordhorn ◽

Konrad Neumann ◽

Thomas Keil ◽

Stefan N. Willich ◽

Sylvia Binting

Keyword(s):

United States ◽

Infant Mortality ◽

Infant Death ◽

Immunization Coverage ◽

The United States ◽

Mortality Rates ◽

Sleep Position ◽

Live Births ◽

Unexpected Infant Death ◽

Rate Ratios

Abstract Background Sudden unexpected infant death (SUID) continues to be a major contributor to infant mortality in the United States. The objective was to analyze time trends in SUID and their association with immunization coverage. Methods The number of deaths and live births per year and per state (1992–2015) was obtained from the Centers for Disease Control and Prevention (CDC). We calculated infant mortality rates (i.e., deaths below one year of age) per 1000 live births for SUID. We obtained data on immunization in children aged 19–35 months with three doses or more of diphtheria-tetanus-pertussis (3+ DTP), polio (3+ Polio), and Haemophilus influenzae type b (3+ Hib) as well as four doses or more of DTP (4+ DTP) from the National Immunization Survey, and data on infant sleep position from the Pregnancy Risk Assessment Monitoring System (PRAMS) Study. Data on poverty and race were derived from the Current Population and American Community Surveys of the U.S. Census Bureau. We calculated mean SUID mortality rates with 95% confidence interval (CI) as well as the annual percentage change using breakpoint analysis. We used Poisson regression with random effects to examine the dependence of SUID rates on immunization coverage, adjusting for sleep position and poverty (1996–2015). In a second model, we additionally adjusted for race (2000–2015). Results Overall, SUID mortality decreased in the United States. The mean annual percent change was − 9.6 (95% CI = − 10.5, − 8.6) between 1992 and 1996, and − 0.3 (95% CI = − 0.4, − 0.1) from 1996 onwards. The adjusted rate ratios for SUID mortality were 0.91 (95% CI = 0.80, 1.03) per 10% increase for 3+ DTP, 0.88 (95% CI = 0.83, 0.95) for 4+ DTP, 1.00 (95% CI = 0.90, 1.10) for 3+ polio, and 0.95 (95% CI = 0.89, 1.02) for 3+ Hib. After additionally adjusting for race, the rate ratios were 0.76 (95% CI = 0.67, 0.85) for 3+ DTP, 0.83 (95% CI = 0.78, 0.89) for 4+ DTP, 0.81 (95% CI = 0.73, 0.90) for 3+ polio, and 0.94 (95% CI = 0.88, 1.00) for 3+ Hib. Conclusions SUID mortality is decreasing, and inversely related to immunization coverage. However, since 1996, the decline has slowed down.

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