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. 2025 Jul 25:13:1623238.
doi: 10.3389/fped.2025.1623238. eCollection 2025.

Global, regional, and national burden of sudden infant death syndrome and the impact of COVID-19: a trend and health inequality analysis based on the global burden of disease study 2021

Xinkuo Zheng #  1 , Meishen Liu  2 , Xingwei Zhao  3 , Xiuqi Xu  1 , Wei Tao  4 , Ling Wu  1 , Weijia Sun  1 , Yuhang Dong  5 , Yalin Xi #  1
Affiliations

Global, regional, and national burden of sudden infant death syndrome and the impact of COVID-19: a trend and health inequality analysis based on the global burden of disease study 2021

Xinkuo Zheng et al. Front Pediatr. .

Abstract

Background: Current sudden infant death syndrome (SIDS) epidemiological patterns and COVID-19 impacts remain uncertain. We therefore conducted this global, regional, and national epidemiological study using data from the Global Burden of Disease Study (GBD) 2021.

Methods: This study analyzed GBD-based population data on SIDS disability-adjusted life years (DALYs). Age-standardized DALY rates (ASDR; per 100,000 population) with 95% uncertainty intervals (UIs) were calculated for 204 countries and territories, stratified by age, location, and socio-demographic index (SDI).

Results: In 2021, the ASDR of SIDS accounted for 44.16 (95% UI: 25.70-59.26) per 100,000 population globally, which was a 58.97% decrease from 1990. The low and low-middle SDI quintiles exhibited a disproportionately higher disease burden of SIDS among the five SDI quintiles in 2021. Higher sociodemographic status showed an inverse association with SIDS burden, with high-SDI countries demonstrating a greater reduction compared to low-SDI counterparts from 1990 to 2021 based on age-period-cohort analysis. Although the global burden of SIDS had maintained a sustained downward trend prior to the pandemic, COVID-19 disruptions may have attenuated mitigation progress, with trend analysis suggesting a possible plateau in SIDS burden during this period rather than continued decline. Study findings indicate that although the global incidence of SIDS has shown a steady decline, persistent regional disparities underscore long-standing public health challenges.

Conclusion: The burden of SIDS-related DALYs remains substantial, and its post-pandemic evolution trends necessitate dynamic tracking through robust epidemiological surveillance systems.

Keywords: epidemiology; global burden of disease study; health inequality analysis; risk factors; sudden infant death syndrome.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
DALYs of SIDS across 204 countries and territories. (A) DALYs number in 2021 (B) ASDR in 2021 (C) EAPC between 1990 and 2021. DALYs, disability-adjusted life years; SIDS, sudden infant death syndrome; ASDR, age standardized Dalys rate; EAPC, estimated annual percentage changes.
Figure 2
Figure 2
The ASDR of SIDS by SDI in 2021. (A) For global and 21 geographic regions, (B) For 204 countries and territories. ASDR, age standardized disability-adjusted life years rate; SIDS, sudden infant death syndrome; SDI, socio-demographic index.
Figure 3
Figure 3
Changes in proportion of DALYs attributable to risk factors of SIDS for global and five SDI regions, 1990–2021. DALYs, disability-adjusted life years; SIDS, sudden infant death syndrome; SDI, socio-demographic index.
Figure 4
Figure 4
Health inequality regression curves (A) and concentration curves (B) for the DALYs of SIDS. DALYs, disability-adjusted life years; SIDS, sudden infant death syndrome; SDI, socio-demographic index.
Figure 5
Figure 5
Frontier analysis exploring the relationship between SDI and ASDR for SIDS, 1990–2021. ASDR, age standardized disability-adjusted life years rate; SIDS, sudden infant death syndrome; SDI, socio-demographic index.
See this image and copyright information in PMC

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