Impact of COVID-19 Pandemic Interventions on Sudden Unexpected Death in Infancy Incidence in France.

Objective: To study the impact of nonpharmaceutical interventions implemented during the COVID-19 pandemic on the monthly incidence of sudden unexpected death in infancy (SUDI) cases overall and those with a viral or bacterial identification.
Study Design: We conducted an interrupted time-series analysis using seasonally adjusted Poisson regression models from the French national prospective and multicenter SUDI registry, that included all SUDI cases below the age of 1 year who died from 2016 to 2021 in mainland France.
Results: Of 998 SUDI cases analyzed, 750 were recorded during the prepandemic period (January 2016 through March 2020) and 248 during the NPI period (April 2020 through December 2021). We found a significant seasonal pattern of overall monthly SUDI incidence, with a peak observed periodically from November to February. The monthly SUDI incidence decreased significantly from the prepandemic to NPI periods (adjusted incidence rate ratio 0.83 [95% CI 0.72-0.96]). In particular, the monthly incidence of SUDI cases with a viral or bacterial identification decreased significantly, while no significant difference was found for SUDI cases without a viral or bacterial identification.
Conclusions: Nonpharmaceutical interventions were associated with a significant change in the incidence of SUDI cases with a viral or bacterial identification. Further investigations are needed to analyze the pathophysiologic role of viruses and bacteria in the SUDI.
Competing Interests: Declaration of Competing Interest The French SUDI registry receives main funding from AXA, France; MSDAvenir, France; Sanofi Pasteur-MSD, France; the French national public health agency (Santé Publique France), France; the National Institute of Health and Medical Research (Inserm), France; and 3 French parent associations (SA VIE, Naitre et Vivre, and Les Rires d'Anna); it also received gifts from private organizations and companies. This particular work was supported by the Fondation de France (Alliance “Tous unis contre le virus”, grant n°APHP220322). Funders were not involved in the collection, analysis, and interpretation of data, in the writing of the report, or in the decision to submit the paper for publication. No support from any organization for the submitted work, no financial relationships with any organizations that might have an interest in the submitted work, and no other relationships or activities that could appear to have influenced the submitted work.
(Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)