Clinical, Economic, and Humanistic Burden of SIDS/SUID in the USA and Europe

OBJECTIVES: A targeted literature review was conducted to understand the burden of illness of sudden infant death syndrome (SIDS) or sudden unexpected infant death (SUID) in the USA and Europe.

METHODS: Relevant studies reporting data on the clinical, humanistic, and economic burden of SIDS/SUID were identified using electronic databases (MEDLINE, Embase, Econlit and the Cochrane Library), and grey literature searches, in April 2024. There was no restriction on intervention or comparator.

RESULTS: Of the 66 included studies, 63 reported data on clinical, two on economic, and one on humanistic burden. Six studies reported SIDS/SUID rates in USA and Europe, and overall there was a downward trend in annual SIDS/SUID rates. The most frequently identified maternal risk factors were smoking, alcohol use, drug use, preterm birth, psychiatric illness, multiparity, not breast feeding, and family history of SIDS/SUID, while unsafe sleep environments, low birthweight, male gender, black race, infections and prematurity were infant-related factors. Socioeconomic status was also a risk factor. Only two studies evaluated the association between vaccines and SIDS/SUID, with contradictory results. The economic burden studies focused on mental health and smoking status. The untreated maternal mental health cost attributable to SIDS was $1.3 million, and the economic benefits per woman for quitting smoking were $4700 (95% CI $2700–$6800). Humanistic burden was described in a thematic analysis, reporting role confusion as the most prominent behavioural symptom contributing to prolonged grief disorder in bereaved mothers.

CONCLUSIONS: Although SIDS/SUID rates have declined, they remain among the leading causes of infant death in the USA and Europe. Published research on economic and humanistic burden of SIDS/SUID is sparse, and standardisation of SIDS or SUID definition is required to allow reliable research.