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. 2017 Sep;28(5):728-734.
doi: 10.1097/EDE.0000000000000703.

Ambient Temperature and Sudden Infant Death Syndrome in the United States

Iny Jhun  1 , Douglas A Mata, Francesco Nordio, Mihye Lee, Joel Schwartz, Antonella Zanobetti
Affiliations

Ambient Temperature and Sudden Infant Death Syndrome in the United States

Iny Jhun et al. Epidemiology. 2017 Sep.

Abstract

Background: Sudden infant death syndrome (SIDS) is a leading cause of infant mortality in the United States. While thermal stress is implicated in many risk factors for SIDS, the association between ambient temperature and SIDS remains unclear.

Methods: We obtained daily individual-level infant mortality data and outdoor temperature data from 1972 to 2006 for 210 US cities. We applied a time-stratified case-crossover analysis to determine the effect of ambient temperature on the risk of SIDS by season. We stratified the analysis by race, infant age, and climate.

Results: There were a total of 60,364 SIDS cases during our study period. A 5.6°C (10°F) higher daily temperature on the same day was associated with an increased SIDS risk of 8.6% (95% confidence interval [CI] = 3.6%, 13.8%) in the summer, compared with a 3.1% decrease (95% CI = -5.0%, -1.3%) in the winter. Summer risks were greater among black infants (18.5%; 95% CI = 9.3%, 28.5%) than white infants (3.6%; 95% CI = -2.3%, 9.9%), and among infants 3-11 months old (16.9%; 95% CI = 8.9%, 25.5%) than infants 0-2 months old (2.7%; 95% CI = -3.5%, 9.2%). The temperature-SIDS association was stronger in climate clusters in the Midwest and surrounding northern regions.

Conclusions: Temperature increases were associated with an elevated risk of SIDS in the summer, particularly among infants who were black, 3 months old and older, and living in the Midwest and surrounding northern regions.

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Conflict of interest statement

Conflicts of interest: The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Location of 210 cities by climate cluster. Honolulu, Hawaii (cluster 7) and Anchorage, Alaska (cluster 2) are not shown.
Figure 2
Figure 2
Percent increase in SIDS for a 5.6 °C (10 °F) increase in same-day temperature (lag 0), prior day temperature (lag 1), and 2 days prior temperature (lag 2) by season across 210 cities (1972-2006). 95% confidence intervals are shown.
Figure 3
Figure 3
Percent increase in SIDS for a 5.6 °C (10 °F) increase in same-day temperature by season across 210 cities (1972-2006), stratified by race (A) and age (0-2 months vs. 3-11 months) (B). 95% confidence intervals are shown.
Figure 3
Figure 3
Percent increase in SIDS for a 5.6 °C (10 °F) increase in same-day temperature by season across 210 cities (1972-2006), stratified by race (A) and age (0-2 months vs. 3-11 months) (B). 95% confidence intervals are shown.
Figure 4
Figure 4
Percent increase in SIDS for a 5.6 °C (10 °F) increase in same-day temperature by season across 210 cities, stratified by time period (1972-1993 vs. 1994-2006) and age (0-2 months vs. 3-11 months).
Figure 5
Figure 5
Percent increase in SIDS for a 5.6 °C (10 °F) increase in same-day temperature by season and climate cluster (1972-2006).
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