Epidemiologic risk factors for sudden infant death syndrome (SIDS)

General factors

Low birth weight

Racial/ethnic differences*^[1]

Gender – Male slightly greater than female^[2]

Climate – Higher risk in cold versus warm months

Maternal and antenatal factors

Smoking, illicit drugs

Young, single parent, no high school degree

Late or no prenatal care

Poor gestational weight gain

Pregnancy complications (placenta previa, abruption, premature rupture of membranes)

Anemia

Urinary tract infection, sexually transmitted disease

Short interpregnancy interval

Neonatal factors

Prematurity

Small for gestational age

Twins

Vital signs at birth – Not a risk

Apnea of prematurity – Not a risk

Post-neonatal factors

Prone sleep position – At least twofold increased risk^[1]

Sleep environment – Bed-sharing, soft sleep surfaces, loose bedding accessories, overheating

Recent gastrointestinal illness

Listlessness

Breastfeeding – Reduces risk

Pacifier use – Reduces risk

Recent upper respiratory infection – Not a risk

Immunizations – Not a risk

* In the United States, risks are highest in Black and American Indian/Alaskan native infants, followed by non-Hispanic White infants, and are lowest in Asian/Pacific Islander and Hispanic infants^[1].

References:

Moon RY, Task force on sudden infant death syndrome. SIDS and Other Sleep-Related Infant Deaths: Evidence Base for 2016 Updated Recommendations for a Safe Infant Sleeping Environment. Pediatrics 2016; 138.
Carpenter RG, Irgens LM, Blair PS, et al. Sudden unexplained infant death in 20 regions in Europe: case control study. Lancet 2004; 363:185.

Additional data from: Hoffman HJ, Damus K, Hillman L, Krongrad E. Risk factors for SIDS. Results of the National Institute of Child Health and Human Development SIDS Cooperative Epidemiological Study. Ann N Y Acad Sci 1988; 533:13.

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Epidemiologic risk factors for sudden infant death syndrome (SIDS)