Geographic Variation in Sudden Unexpected Infant Death in the United States
- Edwin A.Mitchell ,
- Xiaohan Yan ,
- Shirley You Ren ,
- Tatiana M. Anderson ,
- Jan-Marino Ramirez ,
- Juan M. Lavista Ferres ,
- Richard Johnston
The Journal of Pediatrics | , Vol 220: pp. 49-55
Objectives
To assess the geographic variation of sudden unexpected infant death (SUID) and test if variation in geographic factors, such as state, latitude, and longitude, play a role in SUID risk across the US.
Study design
We analyzed the Centers for Disease Control and Prevention’s Cohort Linked Birth/Infant Death dataset (2005-2010; 22 882 SUID cases, 25 305 837 live births, rate 0.90/1000). SUID was defined as infant deaths (ages 7-364 days) that included sudden infant death syndrome, ill-defined and unknown cause of mortality, and accidental suffocation and strangulation in bed. SUID geographic variation was analyzed using 2 statistical models, logistic regression and generalized additive model (GAM).
Results
Both models produced similar results. Without adjustment, there was marked geographic variation in SUID rates, but the variation decreased after adjusting for covariates including known risk factors for SUID. After adjustment, nine states demonstrated significantly higher or lower SUID mortality than the national average. Geographic contribution to SUID risk in terms of latitude and longitude were also attenuated after adjustment for covariates.
Conclusion
Understanding why some states have lower SUID rates may enhance SUID prevention strategies.
© 2020 Elsevier Inc. All rights reserved