A study led by researchers at Penn State College of Medicine has found that the risk of sudden unexpected infant death (SUID) and sudden infant death syndrome (SIDS) increased during the COVID-19 pandemic, particularly in 2021. The findings, published in JAMA Network Open, show that monthly increases in SUID in 2021 were linked to a resurgence of seasonal respiratory viruses, such as respiratory syncytial virus (RSV), suggesting a potential association between altered infectious disease transmission and SUID rates. Despite efforts to educate parents about safe sleep practices, including placing babies on their backs, there continues to be a high rate of SUID.
SUID is defined as the unexpected death of an infant under the age of one year from known and unknown causes, while SIDS is a type of SUID that occurs during sleep and remains unexplained even after investigation. In the United States, approximately 3,700 infants die unexpectedly each year, with SIDS accounting for about one-third of SUID cases. The research team analyzed SUID and SIDS rates during the pandemic compared to the period prior, using data from the Centers for Disease Control and Prevention (CDC) from March 2018 to December 2021, totaling 14,308 SUID cases.
The study revealed that the risk of both SUID and SIDS increased during the pandemic, with the greatest rise observed in 2021 when rates spiked by 9% and 10%, respectively, compared to the pre-pandemic period. A notable shift in SUID rates was observed from June to December 2021, with monthly rates increasing by 10% to 14% compared to pre-pandemic levels. The interruption of respiratory illness spread, including RSV, during 2020 due to pandemic mitigation measures led to low rates, but as these restrictions were lifted, RSV cases surged between June and December 2021.
The increase in RSV-related hospitalizations during an “off-season” for the virus closely mirrored the monthly changes in SUID rates observed in 2021. The researchers suggest that infections like RSV may amplify factors that make babies vulnerable to SUID and SIDS, potentially contributing to a portion of cases. Further research is needed to understand the role of infections in sudden infant deaths and whether viruses like RSV could play a significant role. Safe sleep practices remain crucial, especially when babies are ill, and caregivers are encouraged to continue placing babies on their backs, avoiding soft bedding, and not sharing a bed.
Co-author Erich Batra, an associate professor at Penn State College of Medicine, emphasized the importance of safe sleep practices, particularly when infants are sick. He highlighted the need for ongoing education and awareness around safe sleep guidelines to help reduce the risk of SUID and SIDS. The research team, which included other Penn State College of Medicine authors, underscored the necessity for further exploration of the link between infections and sudden infant deaths to better protect vulnerable infants.
