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De Visme S, Chalumeau M, Levieux K, Patural H, et al. National Variations in Recent Trends of Sudden Unexpected Infant Death Rate in Western Europe. J Pediatr. 2020 Jun 22. pii: S0022-3476(20)30755.

Objective: to study recent epidemiological trends of sudden unexpected death in infancy (SUDI) in Western Europe.

Study design: Annual national statistics of death causes for 14 Western European countries from 2005 to 2015 were analyzed. SUDI cases were defined as infants younger than one year with the underlying cause of death classified as “sudden infant death syndrome” (SIDS), “unknown/unattended/unspecified cause” or “accidental threats to breathing”. Poisson regression models were used to study temporal trends of SUDI rates and source of variation.

Results: From 2005 to 2015, SUDI accounted for 15,617 deaths, for an SUDI rate of 34.9 per 100,000 live births. SUDI was the second most common cause of death after the neonatal period (22.1%) except in Belgium, Finland, France and United Kingdom, where it ranked first. The overall SUDI rate significantly decreased from 40.2 to 29.9 per 100,000, with a significant rate reduction experienced for six countries, no significant evolution for seven countries, and a significant increase for Denmark. The SIDS/SUDI ratio was 56.7%, with a significant decrease from 64.9% to 49.7% during the study period, and ranged from 6.1% in Portugal to 97.8% in Ireland. We observed between-country variations in SUDI and SIDS sex ratios.

Conclusions: In studied countries, SUDI declined during the study period but remained a major cause of infant deaths, with marked between-country variations in rates, trends and components. Standardization is needed to allow for comparing data to improve the implementation of risk-reduction strategies.

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