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Original Article
- Spatiotemporal analysis of sudden infant death syndrome incidence in Korea, 2013–2023
- Seungbae Jeon, Minsu Cha, Sunghyun Yun
- Epidemiol Health. 2026;48:e2026027. Published online June 10, 2026
- DOI: https://doi.org/10.4178/epih.e2026027
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AbstractOBJECTIVES
This study examined temporal trends and geographic variation in sudden infant death syndrome (SIDS) incidence in Korea.METHODSWe analyzed a nationwide cardiac arrest registry to identify SIDS cases from 2013 to 2023. The study period was divided into 3 phases: pre-pandemic (2013–2019), pandemic (2020–2021), and post-pandemic (2022–2023). Incidence rate ratios (IRRs) and 95% confidence intervals (CIs) were estimated using Poisson regression, whereas standardized incidence ratios (SIRs) and 95% credible intervals (CrIs) were derived from Bayesian spatial models across all administrative districts. Spatial clustering was evaluated using Moran’s I.RESULTSOverall, 884 eligible cases were identified: 575 in the pre-pandemic period, 172 in the pandemic period, and 137 in the post-pandemic period. SIDS incidence increased significantly from the mid-2010s onward, with an annual increase of approximately 8–9%. Compared with the pre-pandemic period, SIDS incidence was significantly higher during the pandemic period (IRR, 1.52; 95% CI, 1.28 to 1.80) and the post-pandemic period (IRR, 1.34; 95% CI, 1.11 to 1.61). Spatial clustering of SIDS incidence increased progressively across the 3 periods (Moran’s I: 0.359, 0.654, and 0.952, respectively; p<0.001). Pyeongtaek-si, Gyeonggi-do, was the only district with a significantly increased SIR in the pre-pandemic period (posterior mean, 1.602; 95% CrI, 1.007 to 2.424); no district met the significance thresholds in the subsequent periods.CONCLUSIONSSIDS incidence in Korea has increased significantly since the mid-2010s, with progressive spatial clustering toward southwestern regions across the 3 study periods. The emergence of high-incidence and low-incidence clusters underscores the need for targeted interventions. -
SummaryKorean summary
본 연구는 2013년부터 2023년까지 전국 급성심장정지조사 데이터를 활용하여 국내 영아돌연사증후군 발생률이 2014~2016년 이후 연간 약 8~9%씩 유의하게 증가하고 있으며, 팬데믹 및 팬데믹 이후 시기에 발생률이 유의하게 높았음을 확인하였다. 베이즈 공간 분석 결과, 공간적 군집화가 팬데믹 전·중·후 시기에 걸쳐 점진적으로 강화되어(Moran's I: 0.359→0.654→0.952) 수도권은 저위험, 전라남도를 중심으로 한 남서부 지역은 고위험 군집으로 나타났다. 이러한 결과는 고위험 지역을 대상으로 한 안전 수면 교육, 모유 수유 증진, 지역 감시 체계 강화 등 맞춤형 예방 전략의 필요성을 뒷받침한다.Key Message
Despite declining global sudden infant death syndrome (SIDS) incidence, recent nationwide trends and spatiotemporal patterns in Korea remain poorly characterized. This study showed significantly higher SIDS incidence during pandemic (2020–2021) and post-pandemic (2022–2023) periods than during pre-pandemic period (2013–2019). Bayesian spatial modeling revealed progressively stronger geographic clustering, with low-risk clusters in the capital region (Seoul and Gyeonggi-do) and high-risk clusters in southwestern regions (Jeollanam-do). These findings support geographically targeted interventions, including preventive education, breastfeeding promotion, and strengthened regional surveillance, to reduce the growing epidemiological disparities in SIDS risk among Korean infants.
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