Social Factors Associated with Sudden Unexpected Infant Death

To characterize social factors associated with sudden unexpected infant death (SUID), we examined distribution of social factors across infant race, ethnicity, cause of death (medical, injury-related, unknown) and investigator-derived death grouping utilizing a multi-jurisdictional case registry.

Retrospective analysis of Centers for Disease Control and Prevention SUID and Sudden Death in the Young Case Registry for infant deaths occurring 2015-2020, including child death review team-compiled clinical and investigative information.

Of 2212 infants who experienced SUID, social factors including caregiver criminal history, substance use, and intimate partner violence were associated with lower odds of medical cause of death versus other causes. Over one-third (n = 226, 36%) of infants with injury-related deaths had caregivers with substance use concerns; caregiver substance use was common among SUID overall (n = 753, 34%). Utilizing an investigator-derived schema, both injury-related deaths and undetermined deaths were grouped together and social factors compared across that cohort versus deaths from medical causes; no statistically significant differences in social factors were identified across groups.

Utilizing a multi-jurisdictional registry, relationships between social factors and cause of death among infants experiencing SUID were identified; social factors (caregiver criminal history, substance use, intimate partner violence) were associated with lower odds of medical cause of death versus other causes. Distribution of social factors among infants experiencing SUID may contribute to emerging disparities and requires further study; efforts are needed to improve social factor data quality. SUID prevention efforts should address impact of social factors on fatality vulnerability and advocacy for social policy change.