Risk factors for sudden infant death syndrome following the prevention campaign in New Zealand: A prospective study
Risk factors for sudden infant death syndrome following the prevention campaign in New Zealand: A prospective study
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DOI：
10.1542/peds.100.5.835
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发表时间：
1997-11-01
期刊：
影响因子：
8
通讯作者：
Taylor, BJ
中科院分区：
文献类型：
--
作者：
Mitchell, EA;Tuohy, PG;Taylor, BJ
目标。为了确定婴儿猝死综合症的危险因素（SIDMethods。社区儿童保健护士在 2 年（1991 年 10 月 1 日至 1993 年 9 月 30 日）期间收集了新西兰出生的所有婴儿初次接触时和 2 个月时的数据。结果。新生儿后年龄组中有 232 例 SIDS 病例（2.0/1000 活产），并将这些数据与 1200 例随机选择的对照进行比较获得了 127 例 (54.7%) 和 922 例 (76.8%) 对照组的信息。对先前确定的可改变的危险因素进行了检查，婴儿俯卧睡姿的患病率非常低（初次接触时为 0.7%，2 个月时为 3.0%），但仍与 SIDS 风险增加有关。此外，与仰卧睡姿相比，侧睡姿势也增加了 SIDS 风险。调整后的比值比 (OR) = 6.57；95% 置信区间 (CI) = 1.71, 25.23）发现，母亲吸烟与婴儿猝死综合症的风险增加有关。初次接触时同床为 5.02（95% CI = 2.01, 12.46），2 个月时同床为 5.02（95% CI = 1.05, 24.05）。 在这项研究中，母乳喂养与 SIDS 风险的显着降低没有统计学意义。确定的 SIDS 的其他危险因素包括：未婚母亲、较早离校、年轻母亲、以前怀孕次数较多、迟到。产前护理、怀孕期间吸烟、男婴、毛利族、低出生体重和妊娠期较短。结论是，在调整潜在的混杂因素后，俯卧位和侧卧位睡姿、母亲吸烟以及共用床位和母亲吸烟与 SIDS 风险显着增加相关，从侧卧睡姿改为仰卧位睡姿可能会导致新西兰产妇吸烟的情况大幅减少，而俯卧睡姿的患病率现已下降。然而，吸烟行为也很难改变，但似乎只是对吸烟母亲的婴儿造成风险。在调整了潜在的混杂因素后，母乳喂养似乎并没有显着降低婴儿猝死综合症的风险，但由于这项研究发现的益处很小，因此应谨慎解释这一结果。
Objectives. To identify the risk factors for sudden infant death syndrome (SIDMethods. For 2 years (October 1, 1991 through September 30, 1993) data were collected by community child health nurses on all infants born in New Zealand at initial contact and at 2 months.Results. There were 232 SIDS cases in the postneonatal age group (2.0/1000 live births) and these were compared with 1200 randomly selected control subjects. Information was available for 127 cases (54.7%) and 922 (76.8%) of controls.The previously identified modifiable risk factors were examined. The prevalence of prone sleeping position of the infant was very low (0.7% at initial contact and 3.0% at 2 months), but was still associated with an increased risk of SIDS. In addition, the side sleeping position was also found to have an increased risk of SIDS compared with the supine sleeping position (at 2 months: adjusted odds ratio (OR) = 6.57; 95% confidence interval (CI) = 1.71, 25.23). Maternal smoking was found to be the major risk factor for SIDS. Bed sharing was also associated with an increased risk of SIDS. There was an interaction between maternal smoking and bed sharing on the risk of SIDS. Compared with infants not exposed to either bed sharing or maternal smoking, the adjusted OR for infants of mothers who smoked was 5.01 (95% CI = 2.01, 12.46) for bed sharing at the initial contact and 5.02 (95% CI = 1.05, 24.05) for bed sharing at 2 months. In this study breastfeeding was not associated with a statistically significant reduction in the risk of SIDS.The other risk factors for SIDS identified were: unmarried mother, leaving school at a younger age, young mother, greater number. of previous pregnancies, late attendance for antenatal care, smoking in pregnancy, male infant, Maori ethnicity, low birth weight, and shorter gestation.Conclusions. After adjustment for potential confounders, prone and side sleeping positions, maternal smoking, and the joint exposure to bed sharing and maternal smoking were associated with statistically significant increased risk of SIDS. A change from the side to the supine sleeping position could result in a substantial reduction in SIDS. Maternal smoking is common in New Zealand and with the reduction in the prevalence of prone sleeping position is now the major risk factor in this country. However, smoking behavior has been difficult to change. Bed sharing is also a major factor but appears only to be a risk to infants of mothers who smoke. Addressing bed sharing among mothers who smoke could reduce SIDS by at least one third. Breastfeeding did not appear to offer a statistically significant reduction in SIDS risk after adjustment of potential confounders, but as breastfeeding rates are comparatively good in New Zealand, this result should be interpreted with caution as the power of this study to detect a benefit is small.