Maternal and Obstetric Risk Factors for Sudden Infant Death Syndrome in the United States : Obstetrics & Gynecology

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Maternal and Obstetric Risk Factors for Sudden Infant Death Syndrome in the United States

Getahun, Darios MD, MPH*; Amre, Devendra MD, PhD†; Rhoads, George G. MD, MPH‡; Demissie, Kitaw MD, PhD‡§

Author Information

From the *Department of Family Medicine, University of Medicine and Dentistry (UMDNJ)-Robert Wood Johnson Medical School, New Brunswick, New Jersey; †Department of Pediatrics, Research Center, Sainte-Justine Hospital, Montreal, Quebec, Canada; ‡Division of Epidemiology, UMDNJ–School of Public Health, Piscataway, New Jersey; and §Department of Environmental and Community Medicine, UMDNJ–Robert Wood Johnson Medical School, Piscataway, New Jersey.

Dr. Darios Getahun was a postdoctoral primary care health service research fellow when the research was performed. The fellowship research was supported by the Health Resources and Services Administration (HRSA), T32 PE10011.

Address reprint requests to: Darios Getahun, MD, MPH, Department of Family Medicine, UMDNJ-Robert Wood Johnson Medical School, One Robert Wood Johnson Place-CN 19, New Brunswick, NJ 08903-0019; e-mail: [email protected].

Received September 11, 2003. Received in revised form December 12, 2003. Accepted December 18, 2003.

Obstetrics & Gynecology 103(4):p 646-652, April 2004. | DOI: 10.1097/01.AOG.0000117081.50852.04

OBJECTIVE: 

The objectives of this study were to 1) study the incidence of sudden infant death syndrome (SIDS) among singleton births in the United States and 2) identify maternal and obstetric risk factors for SIDS.

METHODS: 

A cohort of all live births in the United States from 1995 to 1998, formed the source population (n = 15,627,404). The data were obtained from the National Centers for Health Statistics Linked Births and Infant Deaths File. A nested case-control study was used to examine risk factors for SIDS. From this birth cohort, all SIDS deaths (n = 12,404) were first identified (case group). From the remaining non-SIDS births, a 4-fold larger sample (n = 49,616) was randomly selected as a control group.

RESULTS: 

The overall incidence of SIDS was 81.7 per 100,000 live births. More mothers in the case group than in the control group were reported to have placenta previa (odds ratio [OR]: 1.70; 95% confidence interval [CI] 1.24, 2.33), abruptio placentae (OR 1.57; 95% CI 1.24, 1.98), premature rupture of membranes (OR 1.48; 95% CI 1.33, 1.66), or small for gestational age (OR 1.40; 95% CI 1.30, 1.50 for the 10th percentile). SIDS cases were also more likely to be male. Mothers of cases were more likely to be younger, less educated, and nonwhite, and more of them smoked during pregnancy and did not attend prenatal care.

CONCLUSION: 

This analysis confirms the importance of several well known demographic and lifestyle risk factors for SIDS. In addition, placental abnormalities were risk factors for SIDS.

LEVEL OF EVIDENCE: 

II-2

© 2004 The American College of Obstetricians and Gynecologists

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