Characteristics of Sudden Unexpected Infant Deaths - United States, 2020-2024

Sudden unexpected infant death (SUID) accounts for approximately 3,400 deaths among infants aged <1 year in the United States annually. To reduce SUID risk, the American Academy of Pediatrics recommends that infants be placed to sleep supine on a flat, firm, nonshared surface, without soft bedding. SUID vital statistics data do not include details on sleep environment and other contextual factors that are critical for SUID surveillance and prevention. CDC's SUID and Sudden Death in the Young Case Registry (case registry) helps fill this gap. The case registry, a multijurisdictional, population-based active surveillance system, builds on child death review programs, compiling detailed information on deaths in persons aged 0-18 years from multiple data sources. CDC analyzed 2020-2024 case registry data to describe 1) SUID by sociodemographic and sleep environment characteristics, 2) the case registry classification algorithm SUID categories, and 3) death investigation components. Among the 4,861 SUIDs included in this analysis, most decedents were aged 0-3 months, male, Black or African American or White, born full-term, and insured by Medicaid. Unsafe sleep factors were present in at least three fourths of SUIDs. Almost all infants had an autopsy and death investigation, although completed components varied. This newly reported, detailed case registry information can be used by public health professionals and clinicians to improve death investigations, increase understanding of etiologies and risk factors, and enhance focused prevention efforts to reduce SUIDs.