Trends in the Incidence of Sudden Unexpected Infant Death in the Newborn: 1995-2014

Published:February 12, 2018DOI:


      To evaluate the epidemiology of sudden unexpected infant death (SUID) over a 20-year period in the US, to assess the potential frequency of sudden unexpected postnatal collapse in the early days of life, and to determine if SUID rates in the neonatal period (0-27 days) have changed in parallel with rates in the postneonatal periods, including the percentages attributed to codes that include accidental suffocation.

      Study design

      Data from the US Centers for Disease Control and Prevention Linked Birth/Infant Death Records for 1995-2014 were analyzed for the first hour, day, week, and month of life. A comparison of neonatal and postneonatal data related to SUID, including accidental suffocation, was carried out.


      Death records for 1995-2014 indicate that, although SUID rates in the postneonatal period have declined subsequent to the 1992 American Academy of Pediatrics sleep position policy change, newborn SUIDs have failed to decrease, and the percentage of SUIDs attributed to unsafe sleep conditions has increased significantly in both periods; 29.2% of the neonatal cases occurred within the first 6 days of life.


      The frequency of SUIDs during the neonatal period warrants ongoing attention to all circumstances contributing to this category of deaths. The development of a standardized definition of sudden unexpected postnatal collapse and a national registry of these events is recommended. Ongoing research on the effects of early neonatal practices on postneonatal SUID should also be encouraged.



      AAP ( American Academy of Pediatrics), ASSB ( Accidental suffocation and strangulation in bed), CDC ( Centers for Disease Control and Prevention), ICD ( International Classification of Diseases), MSBC ( Mechanical Suffocation Bed or Cradle), SIDS ( Sudden infant death syndrome), SSC ( Skin-to-skin care), SUID ( Sudden unexpected infant death), SUPC ( Sudden unexpected postnatal collapse)
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      Linked Article

      • Skin-to-skin care cannot be blamed for increase in suffocation deaths
        The Journal of PediatricsVol. 200
        • In Brief
          We read with interest the report by Bass et al1; however, we believe the data presented are insufficient to support the authors' conclusions that an increase in suffocation deaths is due, in part, to skin-to-skin care (SSC) and resultant sudden unexpected perinatal collapse.
        • Full-Text
        • PDF
      • Maternal distraction from smartphone use: a potential risk factor for sudden unexpected postnatal collapse of the newborn
        The Journal of PediatricsVol. 200
        • In Brief
          We read the report by Bass et al with great interest; they state that the percentage of sudden unexpected infant deaths attributed to unsafe sleep conditions has increased significantly, with 29.2% of the cases occurring within the first 6 days of life.1 The percentage of neonatal cases attributed to mechanical suffocation bed or cradle/accidental suffocation and strangulation in bed increased 11-fold, from 2.1% in 1995 to 22.7% in 2014. This period corresponds to a rapid rise in the use of smartphones and social media; therefore, we theorize that maternal distraction from smartphone use may be contributing substantially to the rise in sudden unexpected postnatal collapse (SUPC) cases worldwide.
        • Full-Text
        • PDF