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Abstract

After striking changes in rates of sudden unexplained infant death (SIDS) around 1990, four large case-control studies were set up to re-examine the epidemiology of this syndrome. The European Concerted Action on SIDS (ECAS) investigation was planned to bring together data from these and new studies to give an overview of risk factors for the syndrome in Europe.

Data for more than 60 variables were extracted from anonymous records of 745 SIDS cases and 2411 live controls, spread across 20 regions. Logistic regression was used to calculate odds ratios (ORs) for every factor in isolation, and to construct multivariate models. Highly significant risks were associated with prone sleeping and with turning from the side to the prone position. About 48% of cases were attributable to sleeping in the side or prone position. If the mother smoked, significant risks were associated with bed-sharing, especially during the first weeks of life. Mother's alcohol consumption was significant only when baby bed-shared all night. For mothers who did not smoke during pregnancy, the risk for bed-sharing was very small and only significant during the first 8 weeks of life. About 16% of cases were attributable to bed-sharing and roughly 36% to the baby sleeping in a separate room.

Avoidable risk factors such as those associated with inappropriate infants' sleeping position, type of bedding used, and sleeping arrangements strongly suggest a basis for further substantial reductions in SIDS incidence rates.

Additional information

Authors: CARPENTER R G, Medical Statistics Unit, Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London (GB);ENGLAND P D, Medical Statistics Unit, Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London (GB);IRGENS L M, Medical Birth Registry of Norway, University of Bergen (NO);SCHREUDER P, Medical Birth Registry of Norway, University of Bergen (NO);FLEMING P, Institute of Child Health, Royal Hospital for Children, Bristol (GB);BLAIR P S, Institute of Child Health, Royal Hospital for Children, Bristol (GB);HUBER J, University Hospital for Children and Youth, Utrecht (NL);JORCH G, Clinic for General Pediatrics and Neonatology, University of Magdeburg (DE)
Bibliographic Reference: An article published in: The Lancet, Volume 363, Number 9404, 17 January 2004, pp.185-191.
Availability: Available online at: http://www.thelancet.com/journal/vol363/iss9404/full/llan.363.9404.original_research.28360.1
Record Number: 200417309 / Last updated on: 2004-01-19
Category: PUBLICATION
Original language: en
Available languages: en