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Environmental Health Indicators

Sudden unexpected death in infancy (SUDI)

Surveillance Reports and Metadata

Surveillance Report: Sudden unexpected death in infancy (SUDI) (Aug 2025) Download report PDF
Metadata: Sudden unexpected death in infancy (SUDI) (Aug 2025) Download report PDF

Maternal smoking doubles the risk of SUDI

Infants (under one year old) exposed to second-hand smoke are at higher risk of sudden unexpected death in infancy (SUDI) [1]. Having a mother who smokes also doubles their risk of dying from SUDI [2,3].

In 2002–2010, New Zealand had a high SUDI rate compared with other developed countries. New Zealand’s SUDI rate was 1.01 deaths per 1,000 live births, compared with 0.95 in the United States, 0.60 in Japan, 0.50 in Australia, 0.45 in England and Wales, and 0.19 in the Netherlands [4]. The estimated number of SUDI deaths attributable to maternal smoking decreased from 7 in 2010 to 3 in 2019 (based on Mason and Borman (2016) methodology)[5].

Information about this data 

Sudden unexpected death in infancy (SUDI)

Source: Health New Zealand – Te Whatu Ora [6]

Definition: Deaths in children aged under one year of age (<1 year old) with an underlying cause of death in the following ICD-10AM codes: R95, R96, R98, R99, W75, W78, W79. Rates are presented per 1000 live births.

For more information, see the metadata sheet. 

References

  1. US Department of Health and Human Services. 2007. Children and Secondhand Smoke Exposure. Excerpts from The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. 
  2. Anderson HR, & Cook, D. 1997. Passive smoking and sudden infant death syndrome: review of the epidemiological evidence. Thorax, 52, 1003-1009.
  3. Zhang K, Wang X. 2013. Maternal smoking and increased risk of sudden infant death syndrome: A meta-analysis. Legal Medicine 15: 115–121.
  4. Taylor BJ, Garstang J, Engelberts A et al. 2015. International comparison of sudden unexpected death in infancy rates using a newly proposed set of cause-of-death codes. Archives of Disease in Childhood 100(11): 1018–23. DOI: 10.1136/archdischild-2015-308239.
  5. Mason K, Borman B. 2016. Burden of disease from second-hand smoke exposure in New Zealand. New Zealand Medical Journal 129(1432): 16–25.
  6. Health New Zealand – Te Whatu Ora. 2023. Fetal and Infant Deaths web tool. URL: https://tewhatuora.shinyapps.io/fetal-and-infant-deaths-web-tool/
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