SIDS Data and Risk Factors

Each year in the U.S., more than 4,000 infants, without a prior known illness or injury, die suddenly and unexpectedly. As of 2014, Georgia averages three infant deaths per week due to sleep-related causes such as Sudden Unexpected Infant Death (SUID), Sudden Infant Death Syndrome (SIDS) and Accidental Suffocation Strangulation in Bed (ASSB).

Sudden Unexpected Infant Death (SUID) is defined as the death of an infant younger than 1 year of age that occurs suddenly and unexpectedly. After a full investigation, these deaths may be diagnosed as:

  • Suffocation: When no air reaches a baby's lungs, usually caused by a block in the airway
  • Entrapment: When a baby gets trapped between two objects, such as a mattress and wall, and can't breathe
  • Infection: When a baby has a cold or other infection caused by a virus or bacteria that makes breathing difficult
  • Ingestion: When a baby takes something into the mouth that blocks the airway or causes choking
  • Metabolic diseases: Conditions related to how the body functions that can lead to problems with breathing
  • Cardiac arrhythmias: When a baby's heart beats too fast or too slow and affects breathing
  • Trauma (accidental or non-accidental): When a baby experiences an injury
  • SIDS

Sudden Infant Death Syndrome (SIDS) is the sudden death of an infant younger than 1 year of age that cannot be explained even after a full investigation that includes a complete autopsy, examination of the death scene and review of the clinical history. SIDS is a diagnosis of exclusion and only applies when all other possibilities are eliminated.

In some cases, the evidence is not clear or not enough information is available to make a solid diagnosis as to the cause of death, so the death is considered to be of undetermined cause.

Accidental Suffocation and Strangulation in Bed (ASSB) is a type of SUID and a cause-of-death code used for vital statistics purposes. This code is used to identify infant deaths caused by suffocation or asphyxia (blockage of the infant's airway) in a sleeping environment. For example:

  • Suffocation by soft bedding: When soft bedding, a pillow, or a soft mattress blocks the infant's airway.
  • Overlay: When another person shares the sleep surface with the infant and lays on or rolls on top of or against the infant while sleeping, blocking the infant's airway.
  • Wedging or entrapment: When an infant gets trapped between two objects, such as a mattress and wall, bed frame or furniture, ultimately blocking the infant's airway.
  • Strangulation: When something presses on or wraps around the infant's head and neck blocking the airway.

Data Summary: Sleep-related Infant Deaths

SIDS and other sleep-related deaths are a contributing factor to Georgia’s high infant mortality rate, defined as the number of infant deaths in Georgia per 1,000 births. The following graph shows that while the rates of SIDS deaths have dropped, the rates of ASSB have been steadily increasing. 

A line graph showing the rates of SIDS and other sleep-related causes of infant death from 1990 to 2013. The Y axis shows deaths per 1,000 births and ranges from 0 to 1.8. The X axis depicts the years 1990 through 2013. Total SUID deaths declined from ~1.5 in 1990 to 1 in 2013. Total SIDS deaths declined from ~1.3 in 1990 to ~0.5 in 2013. Deaths from unknown causes held steady between 1990 and 2013 at a rate of ~0.2. Deaths from accidental suffocation and strangulation in bed rose from ~0 in 1990 to ~0.2 in 2013.

Source: SOURCE: CDC/NCHS National Vital Statistics System, Period Linked Birth/Infant Death Data

According to the 2014 Georgia Child Fatality Review Panel, there were a total of 158 sleep-related infant deaths in Georgia. The highest rates of deaths occurred in infants between the ages of 1 and 3 months.

2014 Sleep-Related Deaths by Age in Months

Source: Georgia Child Fatality Review Panel Annual Report, 2014

                                                                                                                              While SIDS and other sleep-related deaths can happen to any baby, data from the Centers for Disease Control and Prevention (CDC) show a higher prevalence of SIDS among several minority demographics such as American Indian, Alaska Native and non-Hispanic Black.

Source: SOURCE: CDC/NCHS National Vital Statistics System, Period Linked Birth/Infant Death Data

Sleep-Related Infant Mortality Risk Factors

There are three widely accepted categories of risk factors which contribute to sleep related infant mortality – vulnerable infant, critical development period and outside stressors.  

Further defining each risk category sheds additional light on the connection between demographics, environmental factors and developmental phases that increase risks of SIDS and sleep-related deaths.

Vulnerable Infant

  • Male gender
  • African American or Native American
  • Mothers younger than 20 years old
  • Maternal smoking during pregnancy
  • Low birth weight or prematurity
  • Genetic abnormality

Critical Developmental Period

  • Infants age 0-12 months; specifically 2 to 4 months
  • Infant development phase when most rapid growth happens
  • Transition from intrauterine environment

Outside Stressors

  • Stomach or side sleeping
  • Babies put on their tummies
  • Babies put on their tummies to sleep when they usually sleep on their backs
  • Bed or other surface-sharing
  • Over heating
  • Soft bedding or soft sleep surface
  • Environmental tobacco smoke
  • Alcohol or drug use in caregiver
  • Late or no prenatal care

Source: The Triple-Risk Model. Adapted from “A perspective on neuropathologic findings in victims of the sudden infant death syndrome: the triple-risk model,” by J. J. Filiano & H. C. Kinney, 1994, Biology of the Neonate, 65(3-4), 194-197. Filiano, J. J., & Kinney, H. C. (1994).





Page last updated 03/08/2016