MONDAY, Feb. 12, 2018 (HealthDay News) -- Sudden infant death syndrome (SIDS) claims the lives of some 3,500 babies in the United States each year, but its toll is far heavier in some states than others, health officials report.
"Despite continued updates and refinements to the American Academy of Pediatrics' safe sleep recommendations, declines in [SIDS] have slowed since 1999," said lead researcher Alexa Erck Lambert.
"Our analysis also found that trends in [SIDS] vary by state," she added. "Although some states have experienced notable declines, wide variations in [SIDS] rates by state still exist."
Erck Lambert is with the maternal and infant health branch of the U.S. Centers for Disease Control and Prevention's division of reproductive health.
Although the researchers couldn't explain the trends, one pediatrician suggested that varying smoking rates, along with racial and ethnic differences, may be at play.
The greatest declines in SIDS rates were seen in California, Colorado, the District of Columbia, Florida, Kansas, Missouri, New York, Oregon, Washington and Wisconsin.
On the other hand, the highest SIDS rates were found in Alaska, Arkansas, Alabama, Kentucky and Louisiana. Significant increases in SIDS cases were also seen in these states between 2000-2002 and 2013-2015.
According to Erck Lambert, infant deaths dropped sharply in the 1990s due to a campaign called Back to Sleep, which encourages parents to put their babies on their back to sleep. But since 1999 the drop in infant deaths has basically stalled.
The rate of SIDS cases dropped about 7 percent from 1999 to 2015. From 1990 to 1998, however, these deaths fell nearly 45 percent, the study authors reported.
The researchers can't say why there are state differences or why the number of SIDS cases has flattened.
"The reasons for the trends are outside the scope of this study and impossible to tease out from vital statistics data," Erck Lambert said. "Our goal was to illuminate the trends and state variation."
The report was published online Feb. 12 in the journal Pediatrics.
One specialist said many factors may contribute to the differences in sudden infant death rates.
Dr. Rebecca Carlin is a pediatrician at Children's Health Center Hospital in Washington, D.C., who said maternal smoking has been shown to increase the risk for SIDS.
"All five of the states with the highest and increasing [SIDS] rates also have some of the highest rates of smoking, whereas only one of the nine states with the biggest fall in [SIDS] rates had as high a rate of tobacco use," she said.
In addition, laws that cover training child care providers on infant safety vary from state to state, as do rates of health insurance coverage, said Carlin, who co-authored an editorial that accompanied the study.
"There are also racial differences in [SIDS] rates, with American Indian and Alaskan Native and non-Hispanic African American infants having the highest rates, and Hispanic American and Asian American infants having the lowest rates," she said.
Moreover, some states have home-visiting programs and other initiatives that have been helpful in educating parents on safe sleep, Carlin added.
"In the U.S. as a whole, but particularly in states where the number of [SIDS] deaths are increasing, we need to invest in programs to effectively decrease smoking and substance use, increase prenatal care and promote safe sleep environments in order to better protect infants," she said.
For more on SIDS, visit the U.S. Centers for Disease Control and Prevention.