روند ملی و دولتی در مرگ ناگهانی نوزاد: 1990-2015 National and State Trends in Sudden Unexpected Infant Death: 1990–2015

Results During the study period (1990–2015), SUID rates per 100000 live births declined from 154.6 in 1990 to 92.4 in 2015. Among SUID subtypes, the SIDS rate was highest, followed by unknown cause and ASSB rates (‍Fig 1). In 1990, SIDS accounted for most SUIDs and occurred at a rate of 130.3 deaths per 100000 live births. At that time, the SIDS rate was almost 40 times higher than the ASSB rate (3.4 per 100000) and 6 times higher than the unknown cause rate (20.9 per 100000). Over the study period, the gap between SIDS rates and the rates of the other SUID subtypes narrowed. In 2015, the SIDS rate was <2 times higher than either ASSB or unknown cause (39.3 vs 23.0 and 30.0 deaths per 100000 live births, respectively). In Table 1, we describe the overall PC for SUID and SUID subtypes over the study period and for the years of 1990–1998 and 1999–2015. From 1990 through 2015, there was a PC of −40.5% for SUID, −70.9% for SIDS, 45.1% for unknown cause, and 671.0% for ASSB (‍Table 1). From 1990 through 1998, the PC was −44.6% for SUID, −50.9% for SIDS, −14.1% for unknown cause, and 30.2% for ASSB (‍Table 1). From 1999 through 2015, the PC was −7.2% for SUID, −35.8% for SIDS, and 183.8% for ASSB, with no significant change in unknown cause (‍Table 1). In analyses of state-specific SUID trends, several patterns emerged (‍Table 2). All states, but Louisiana and Alabama, had a reduction in SUID when 1990–1992 was compared with 2013–2015. In 2013–2015, 18 states met or exceeded the HP2020 SUID goal of 84 deaths per 100000 live births, compared with 16 states in 2000–2002 and 1 state in 1990–1992. California, Colorado, the District of Columbia, Florida, Kansas, Missouri, New York, Oregon, Washington, and Wisconsin had significant percentage declines in SUID rates when 2000–2002 was compared with 2013–2015. The greatest declines occurred in the District of Columbia (−44.5%), Colorado (−40.8%), and Wisconsin (−37.8%).