SUID Rate per 100 000 Live Births a (95% Confidence Interval) 15 By law, the official cause of death for SUID cases must be determined and reported by the medicolegal death investigation system (ie, medical examiner and coroners). 18 The ICD-10 is used for official reporting of mortality statistics in the United States and other nations. SUID included 3 underlying cause-of-death classifications 16, 17 coded per the International Classification of Diseases, 10th Revision (ICD-10): SIDS (R95), unknown cause (R99), and ASSB (W75). 15 Analyses were restricted to infants born to US residents from the 50 states and District of Columbia. In the period-linked file, infants (<365 days) who died in the United States in a given calendar year are linked back with the corresponding birth certificate. We calculated overall and cause-specific SUID rates per 100 000 live births along with 95 confidence intervals. 14 This period file was selected to examine changes in SUID before (2015–2019) and during (2020) the COVID-19 pandemic 2020 is the last year final national SUID data currently available. We used US period-linked birth and infant death files for 2015 to 2020. 6, 7 Monitoring changes in SUID rates before and during the COVID-19 pandemic can provide insight to understand if pandemic factors affected SIDS and SUID rates.

3– 5 Furthermore, pandemic-related losses of or changes in child care arrangements may also have led to an increased SIDS or SUID risk due to unaccustomed infant sleep positioning and other unsafe sleep practices.

Clinical follow-up and support services are times when safe sleep messages are communicated, smoking cessation is encouraged, immunizations are administered, and breastfeeding counseling is given, all of which are protective factors against SIDS and SUID. 2 Limited access to these encounters and services might have increased the risk of SIDS and other SUIDs. Increased pressures on families, caregivers, and communities during the pandemic may have limited opportunities for clinical follow-up after birth (eg, early postpartum discharges and timely well-baby visits after birth hospitalization) and access to safety-net supports (eg, Women, Infants, and Children Supplemental Nutrition Program Healthy Start). The COVID-19 pandemic may have affected sudden unexpected infant deaths (SUID) in several ways.

Number of child covid deaths in us