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Strengthening the evidence for maternal and child health programs

SUID/SIDS Gateway

Statistics

NOTE: The project that funded development of this page has ended, so it will no longer be updated. It is presented as an enduring, historical reference.

Overview

The final infant mortality rate in the United States for 2010 was 6.15 infant deaths per 1,000 live births. Sudden infant death syndrome (SIDS) is the third leading cause of infant death for 2010 and the first leading cause of death among infants ages 1–12 months1.

In 2010, there were a total of 3,610 or 0.9 sudden unexpected infant deaths (SUID) per 1,000 live births, accounting for 15 percent of all infant deaths2.  SUID, as defined by Healthy People 2020 objective MICH 1.9 (Reduce the rate of infant deaths from sudden unexpected infant deaths) includes SIDS, unknown cause, and accidental suffocation and strangulation in bed32,063 of these deaths were attributed to SIDS (ICD-10 code R95); 918 attributed to unknown cause (ICD-10 code R99), and 629 attributed to accidental suffocation and strangulation in bed (ASSB, ICS-10 code W75)4.

Understanding SUID statistics requires knowledge of the shift in the classification of sudden infant death that has taken place in the United States over the last 15 years. The SIDS rate has declined significantly since the Back to Sleep Campaign (now Safe to Sleep Campaign®) was introduced in 1994, with declines occurring in large part during the first several years of the campaign. Since 1998, according to the Centers for Disease Control and Prevention5, it appears that medical examiners and coroners are moving away from classifying deaths as SIDS and calling more deaths accidental suffocation or unknown cause. In addition, practices in investigation and cause-of-death determination are inconsistent, thus hampering the ability to monitor national and state trends, ascertain risk factors, and design and evaluate programs to prevent these deaths. CDC's Sudden Unexpected Infant Death (SUID) Initiative is aimed at improving the investigation and reporting practices of SIDS and SUID.

For more information about sudden infant death classification, see these:

Footnotes

  1. National Center for Health Statistics. Deaths: Final Data for 2010. National Vital Statistics Report v. 61, no. 4, May 8, 2013. Available at http://www.cdc.gov/nchs/data/nvsr/nvsr61/nvsr61_04.pdf
  2. Centers for Disease Control and Prevention, National Center for Health Statistics. Underlying Cause of Death 1999-2010 on CDC Wonder Database, released 2012.  Data are from the Multiple Cause of Death Files, 1999-2010, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at http://wonder.cdc.gov/ucd-icd10.html on 10/18/2013.
  3. U.S. Department of Health and Human Services. Healthy People 2020 Topics & Objectives: Maternal, Infant, and Child Health. Retrieved from http://www.healthypeople.gov/2020/topicsobjectives2020. Accessed 07/31/2013. 
  4. Centers for Disease Control and Prevention, National Center for Health Statistics. Underlying Cause of Death 1999-2010 on CDC Wonder Database, released 2012.  Data are from the Multiple Cause of Death Files, 1999-2010, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at http://wonder.cdc.gov/ucd-icd10.html on 10/18/2013.
  5. Centers for Disease Control and Prevention. Sudden Unexpected Infant Death and Sudden Infant Death Syndrome. Accessed at http://www.cdc.gov/SIDS/SUIDAbout.htm on 10/24/2013.

Chart 1. Infant Mortality* and Sudden Infant Death Syndrome, 1983–-2010

Chart 1. Infant Mortality* and Sudden Infant Death Syndrome per 1,000 Life Births, 1983-2005

* Infant mortality includes deaths from birth to age 1, as distinguished from posteonatal mortality (reported in Table 3), which includes deaths from age 1 month to age 1 year.

Click here to view data table and sources for this chart.

Disparities

The SIDS rate remains significantly higher among certain racial and ethnic groups, including non-Hispanic Blacks and American Indian/Alaska Natives (National Center for Health Statistics' (NCHS) linked birth/infant death data. See Chart 2 below.

More information on these disparities is found in Infant Mortality Statistics from the 2009 Period Linked Birth/Infant Death Set, which notes that in 2009 the infant mortality rate for non-Hispanic black women was 12.40 infant deaths per 1,000 live births, 2.8 times greater than the lowest rate of 4.40 for infants of Asian or Pacific Islander mothers. Rates were also higher for infants of American Indian or Alaska Native (8.47) and Puerto Rican (7.18) mothers.

Chart 2. SIDS Deaths by Race and Ethnicity, 1995–2009

Chart 2. SIDS Deaths by Race and Ethnicity, 1995-2005

* All white for 1995 and 1996; Non-Hispanic white for the period 1997–2009. ** All black for 1995-2001; Non-Hispanic black for the period 2002–2009. *** Includes Alaska Natives for period 1999–2009.

Click here to view data table and sources for this chart.

International

Compared to rates in other developed countries, the U.S. SIDS rate remains high. For example, in 2005, the U.S. rate ranked second highest (after New Zealand) among 13 countries in a research study by Fern Hauck and Kawai Tanabe. The lowest SIDS rates among these countries were in the Netherlands and Japan.

It is important to note that the age of inclusion for SIDS varies from country to country, with some countries defining SIDS as occurring from age 1 week to age 1 year, while others use a range from birth to age 1 year or another range. The authors state that it is likely to be a small effect because the number of SIDS deaths occurring in the first week of life and after age 1 year are very small.

Since SUID rates are not provided in these research findings, it is also unclear whether those rates may have increased as the SIDS rates declined (as has happened in the United States in recent years).

The decline in the SIDS rate in all of these countries is reflected in the overall decline in postneonatal mortality, and, as with the United States, higher rates of these declines occurred earlier in the risk-reduction campaigns in those respective countries.

Chart 3. International SIDS Rates, Ordered from Lowest to Highest SIDS Rate in 2005

Chart 3. International SIDS Rates, ordered from lowest to highest SIDS rate in 2005

Click here to view data table and sources for this chart.

For additional statistics on international infant mortality and SIDS, see the International Society for the Study and Prevention of Perinatal and Infant Death.

Note on Mortality Data Sets

Mortality data from the National Vital Statistics System (NVSS) are a fundamental source of U.S. demographic, geographic, and cause-of-death information. The data is collected using standard forms and model procedures developed by the National Center for Health Statistics (NCHS) in cooperation with regional jurisdictions.  NCHS publishes preliminary data before releasing its final data for a given year, which typically takes 2-3 years to gather and finalize.  However, since SIDS and SUID deaths can be so time-consuming to diagnose, the final statistics are more reliable.

The Linked Birth and Infant Death Data Set combines data from the death certificate with information from the birth certificate for each infant under one year of who dies in the United States, Guam, Puerto Rico, and The Virgin Islands.  The purpose of the linkage is to use the additional variables available from the birth certificate to conduct more detailed analyses of infant mortality patterns. The linked files include information from the birth certificate such as age, race, and Hispanic origin of the parents, birth weight, period of gestation, plurality, prenatal care usage, maternal education, live birth order, marital status, and maternal smoking, linked to information from the death certificate such as age at death and underlying and multiple cause of death. 

The linked birth and infant death data set is a valuable tool for monitoring and exploring the complex inter-relationships between infant death and risk factors present at birth.  Although the data takes longer to gather, it is a more detailed source of information on infant mortality.

Other Resources

Infant Mortality Statistics

Centers for Disease Control and Prevention. 2011. Quick stats: Infant mortality rates by mother’s place of birth and race/ethnicity—United States, 2007. Morbidity and Mortality Weekly Report: Recommendations and Reports 60(26):891.

Centers for Disease Control and Prevention. 2012. Sudden Unexpected Infant Death (SUID). Centers for Disease Control and Prevention.

Centers for Disease Control and Prevention. 2010. Health Data Interactive. Select “Mortality and Life Expectancy” to view tables of data from 2001 to 2009.

Heisler EJ. 2012. The U.S. infant mortality rate: International comparisons, underlying factors, and federal programs. Congressional Research Service.

Hauck F, Tanabe K. 2008. International trends in sudden infant death syndrome stabilization of rates requires further action. Pediatrics 122(3):660–666.

Heron M. 2010. Deaths: Leading causes for 2006. National Vital Statistics Reports 58(14):1–100.

MacDorman MF, Kimeyer S. 2009. The challenge of fetal mortality. NCHS Data Brief (16)1–8.

MacDorman MF, Kimeyer S. 2009. Fetal and perinatal mortality, United States, 2005. National Vital Statistics Reports 57(8):1–19.

MacDorman MF, Mathews MS. 2009. Behind international ranking of infant mortality: How the United States compares with Europe. NCHS Data Brief (23)1–8.

MacDorman MF, Mathews TJ. 2008. Recent trends in infant mortality in the United States. NCHS Data Brief (9)1–8.

MacDorman MF, Mathews TJ. 2011. Understanding racial and ethnic disparities in U.S. infant mortality rates. NCHS Data Brief (74)1–8.

MacDorman MF, Kimeyer SE, Wilson EW. 2012. Fetal and perinatal mortality, United States, 2006. National Vital Statistics Reports 60(8):1–23.

Mathews TJ, MacDorman MF. 2013. Infant mortality statistics from the 2009 period linked birth/infant death data set. National Vital Statistics Reports 61(8):1–46.

Xu J, Kochanek KD, Murphy SL, Tejada-Vera B. 2012. Deaths: Final data for 2009. National Vital Statistics Reports 60(3):1–106.

Statistics on Other Topics

First Candle; Sudden and Unexpected Infant/Child Death and Pregnancy Loss Centers 2010. Program Manual and Trainer’s Guide. Research and statistical resources.

March of Dimes Perinatal Data Center. Peristats. Website providing free access to national, state, county, and city maternal and infant health data.

National Child Death Review. N.d. SUDC fact sheet for NCDR. Fact sheet providing information from the Centers for Disease Control and Prevention on reported incidence of Sudden Unexplained Death in Childhood (SUDC).

National Infant Sleep Position Study (NISP). N.d. Sleep position summary data (1992–2008) for all races and ethnic groups for NISP, developed by National Institute for Child Health and Human Development to examine sleep practices and factors associated with adherence to back-to-sleep recommendations.

Ventura SJ, Curtain MA, Abma JC. 2012. Estimated pregnancy rates and rates of pregnancy outcomes for the United States, 1990–2008. National Vital Statistics Reports 60(7):1–21.

World Health Organization. fMortality Data. Data set including health statistics and health information systems.


Updated October 2013

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.