Branche Tonia, Shapiro Jana, Najera Clarissa, Matoba Nana, Rankin Kristin, Collins James W Jr
Division of Neonatology, Ann and Robert H. Lurie Children's Hospital, 225 E. Chicago Ave, Box 45, Chicago, IL, 60611, USA.
Department of Pediatrics, Feinberg School of Medicine, Northwestern University, 420 E. Superior St, Chicago, IL, 60611, USA.
Matern Child Health J. 2025 May;29(5):660-668. doi: 10.1007/s10995-025-04084-9. Epub 2025 Apr 19.
This study aimed to estimate (1) rates of SUID and its subcategories among infants of U.S.-born and foreign-born women, and (2) the extent to which maternal race/ethnicity modifies the relationship between maternal nativity and SUID rates.
Stratified and adjusted (for traditional demographic, clinical, and behavioral risk factors) Poisson regression analyses were performed on the National Center for Health Statistics linked 2021-2022 live birth-infant death database. Rates of SUID and its subcategories-sudden infant death syndrome (SIDS), accidental suffocation or strangulation in bed (ASSB), and unknown causes-were calculated for infants of women in the four largest U.S. racial/ethnic groups.
Infants of U.S.-born women (n = 5,600,507) had an over three-fold greater SUID rate than infants of foreign-born women (n = 1,594,547): 115.5/100,000 vs. 34.8/100,000, RR = 3.3 (3.0, 3.6). Strikingly, the nativity disparity existed among infants of Non-Hispanic Asian (n = 431,532), Non-Hispanic Black (n = 1,025,573), Hispanic (n = 1,820,734) and Non-Hispanic White (n = 3,722,820) women: RR = 2.4 (1.7, 3.5), 4.9 (4.0, 6.1), 2.3 (2.0, 2.6), and 3.2 (2.5, 4.1), respectively. Maternal nativity disparities in SUID persisted after adjustment, overall (adjRR = 2.5 (2.3, 2.8)) and within each racial/ethnic group. Non-Hispanic Black infants had the widest disparity (adjRR = 3.3 (2.7, 4.1)). Similar results were observed for SIDS, ASSB, and unknown causes.
Infants of U.S.- vs. foreign-born women have higher rates of SUID and its subcategories independent of traditional risk factors. This nativity disparity is widest among Non-Hispanic Black women. These findings warrant further attention and research regarding differences in environment, infant sleep practices and SUID death investigation among foreign-born and U.S.-born women.
本研究旨在估计（1）美国出生和外国出生女性的婴儿中不明原因婴儿死亡（SUID）及其子类别发生率，以及（2）母亲种族/族裔在多大程度上改变了母亲出生地与SUID发生率之间的关系。
对美国国家卫生统计中心2021 - 2022年活产-婴儿死亡关联数据库进行分层和调整（针对传统人口统计学、临床和行为风险因素）的泊松回归分析。计算了美国四大种族/族裔群体中女性所生婴儿的SUID及其子类别——婴儿猝死综合征（SIDS）、床上意外窒息或勒死（ASSB）以及不明原因——的发生率。
美国出生女性的婴儿（n = 5,600,507）的SUID发生率比外国出生女性的婴儿（n = 1,594,547）高出三倍多：115.5/100,000对比34.8/100,000，相对风险（RR）= 3.3（3.0，3.6）。令人惊讶的是，在非西班牙裔亚裔（n = 431,532）、非西班牙裔黑人（n = 1,025,573）、西班牙裔（n = 1,820,734）和非西班牙裔白人（n = 3,722,820）女性所生婴儿中均存在出生地差异：RR分别为2.4（1.7，3.5）、4.9（4.0，6.1）、2.3（2.0，2.6）和3.2（2.5，4.1）。调整后，SUID中母亲出生地差异仍然存在，总体上（调整后RR = 2.5（2.3，2.8））以及在每个种族/族裔群体内部。非西班牙裔黑人婴儿的差异最大（调整后RR = 3.3（2.7，4.1））。SIDS、ASSB和不明原因的情况也观察到类似结果。
美国出生与外国出生女性的婴儿中，SUID及其子类别发生率较高，且与传统风险因素无关。这种出生地差异在非西班牙裔黑人女性中最为明显。这些发现值得进一步关注和研究外国出生和美国出生女性在环境、婴儿睡眠习惯以及SUID死亡调查方面的差异。
