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Racial and Ethnic Disparities in Sudden Unexpected Infant Death Among US Infants Born Preterm

Sunah S Hwang1, Stephanie L Bourque1, Kathleen E Hannan1

  • 1Section of Neonatology, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO.

The Journal of Pediatrics
|May 21, 2023
PubMed

Insights

Sudden unexpected infant death (SUID) rates reveal significant racial and ethnic disparities among US preterm infants. These disparities, particularly for non-Hispanic Black infants, vary considerably across states, necessitating further research into underlying causes.

Area of Science:

  • Public Health
  • Pediatrics
  • Epidemiology

Background:

  • Sudden unexpected infant death (SUID) remains a critical concern in infant mortality.
  • Preterm infants face a higher risk of SUID compared to full-term infants.
  • Existing research suggests potential racial and ethnic disparities in SUID, but state-level variations require further investigation.

Purpose of the Study:

  • To examine racial and ethnic disparities in SUID among preterm infants in the US.
  • To analyze state-specific variations in SUID rates.
  • To investigate the disparity ratio of SUID between non-Hispanic Black (NHB) and non-Hispanic White (NHW) infants across different states.

Main Methods:

  • Retrospective cohort analysis using linked birth and death certificates from all 50 US states (2005-2014).
  • SUID defined using International Classification of Diseases, 9th/10th edition codes.
  • Multivariable models adjusted for maternal and infant characteristics to assess the association between race/ethnicity and SUID.

Main Results:

  • A total of 8,096 SUID cases occurred among 4,086,504 preterm infants (0.2%).
  • SUID rates varied significantly by state, from 0.82/1000 in Vermont to 3.87/1000 in Mississippi.
  • Non-Hispanic Black (NHB) preterm infants had higher adjusted odds of SUID (aOR=1.5) compared to non-Hispanic White (NHW) infants, with significant disparities also observed for Alaska Native/American Indian infants.

Conclusions:

  • Significant racial and ethnic disparities in SUID exist among US preterm infants.
  • There is considerable variation in SUID rates and NHB-NHW disparity ratios across US states.
  • Further research is crucial to identify the specific factors driving these disparities within and between states.
Abstract

Keywords:
prematurityracial and ethnic disparitiessudden unexpected infant death

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