1. Sudden unexpected infant death (SUID) rates were highest among American Indian/Alaska Natives (AIANs), followed by non-Hispanic blacks (NHBs), and lowest among Asian/Pacific Islanders (APIs) and Hispanics.
2. While the most significant decrease in SUID rates was observed among APIs followed by Hispanics and NHBs, rates for NHWs and AIANs did not show a significant decline resulting in a slight narrowing in the disparity gap between NHBs and NHWs.
Study Rundown: According to the CDC, >35% of infant deaths in the United States (US) are caused by SUID, defined as deaths due to sudden infant death syndrome, accidental strangulation and suffocation in bed, and other ill-defined causes of infant death. Despite initial improvements in mortality rates following the 1994 Back-to-Sleep campaign, rates of SUID have remained relatively stable since 2000. While previous studies have identified racial/ethnic disparities in all cause infant mortality, investigators in this study attempted to understand race/ethnicity-specific trends in SUID rates since the campaign (from 1995 to 2013). Results revealed that SUID rates were highest among AIANs, followed by NHBs. SUID rates among APIs, Hispanics, and NHBs all decreased significantly over the examined time period, while the rates for AIANs and non-Hispanic whites (NHWs) showed a more marginal decline. This resulted in a slight narrowing of the disparity gap between NHBs and NHWs, but the relative ranking of SUIDs based on race/ethnicity did not change. This study is limited by the scope of data available from birth-infant death records as well as the fact that infant race/ethnicity was based solely on self-reported maternal race/ethnicity. Results of this study may have implications for developing culturally-appropriate SUID risk-reduction strategies for each racial/ethnic community.
In-depth [cross-sectional study]: Researchers analyzed data on US birth-infant deaths occurring from 1995 to 2013 to evaluate rates of SUID per 100 000 live births by race/ethnicity, including NHWs, NHBs, Hispanics, AIANs, and APIs. They also collected demographic data including sex, age at death, gestational age at death, and season of death. Results showed that APIs experienced the greatest decrease in SUID (annual percentage change (APC): -3.3 p<.0001) followed by Hispanics (APC: -0.8 p=.001) and NHBs (APC -0.7 p<.0001), while the rates among NHWs and AIANs did not decline significantly. SUID rates among AIANs and NHBs were double the rates of NHWs throughout the study period, while APIs consistently had the lowest rates followed by Hispanics. Overall, when compared with NHWs, changes documented in the study resulted in an increase in the survival advantage for Hispanics and APIs and a slight narrowing of the disparity with NHBs. The study also showed that while preterm SUID rates dropped significantly between 1995 to 1997 and 2011 to 2013 for all groups except APIs, the variation in total percentage change by race/ethnicity between periods was minimal (-20% for NHWs, -18% for NHBs, -22% for Hispanics and -15% for AIANs). For all races/ethnicities and both periods, most deaths occurred between 1 to 2 months of age, and the proportion of SUIDs occurring between 5 to 11 months increased significantly for all races/ethnicities except APIs, and the SUID rate was higher for boys among all races/ethnicities.
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