Sudden infant death syndrome: Risk factors for infants found face down differ from other SIDS cases

• Published in: The Journal of pediatrics Vol. 149; no. 5; pp. 630 - 633.e1
• Main Authors: Thompson, John M.D., Thach, Bradley T., Becroft, David M.O., Mitchell, Edwin A.
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.11.2006; Elsevier
• Subjects: Analysis of Variance; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Bedding and Linens - adverse effects; Biological and medical sciences; Case-Control Studies; Emergency and intensive care: neonates and children. Prematurity. Sudden death; Epidemiology; General aspects; Humans; Infant; Infant, Newborn; Intensive care medicine; Medical sciences; New Zealand - epidemiology; Odds Ratio; Pacifiers - adverse effects; Posture; Prone Position; Public health. Hygiene; Public health. Hygiene-occupational medicine; Risk Factors; Sleep; Sudden Infant Death - epidemiology; Sudden Infant Death - etiology; Sudden Infant Death - prevention & control; New Zealand; NFD; FD; SIDS; Human; Case study; Pediatrics; Sudden death; Risk factor; Sudden infant death syndrome; Infant; Face; Epidemiology
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2006.07.041

To test the hypothesis that infants with sudden infant death syndrome (SIDS) found face down (FD) would have SIDS risk factors different from those found in other positions (non–face-down position, NFD). We used the New Zealand Cot Death Study data, a 3-year, nationwide (1987 to 1990), case-control study. Odds ratios (univariate and multivariate) for FD (n = 154) and NFD SIDS (n = 239) were estimated separately, and statistical differences between the two groups were assessed. Of 12 risk factors for SIDS, there were 8 with a statistically significant difference between FD and NFD infants. After adjustment for the potential confounders, younger infant age, Maori ethnicity, low birth weight, prone sleep position, use of a sheepskin, and pillow use were all associated with a greater risk of SIDS in the FD than the NFD group. Sleeping during the nighttime, maternal smoking, and bed-sharing were associated with a risk of SIDS only in the NFD group. Pacifier use was associated with a decreased risk for SIDS only in the NFD group, whereas being found with the head covered was associated with a decreased risk for SIDS for the FD group. Infants with SIDS in the FD position appear to be a distinct subgroup of SIDS. These differences in risk factors provide clues to mechanisms of death in both SIDS subtypes.