Abstract â–¡ 38

This presentation describes the design of a large multi-center case control study of the Sudden Infant Death Syndrome (SIDS) presently under way in 13 forensic medicine centers in Germany (Aachen, Berlin, Erlangen, Essen, Freiburg, Halle, Hannover, Heidelberg, Jena, Leipzig, Magdeburg, Muenchen, and Muenster), coordinated by the Institute for Forensic Medicine in Muenster. The study focuses on pertinent risk factors for SIDS drawing on the results of a pilot study involving 58 SIDS cases and 181 controls. The preliminary results of the pilot study carried out will be presented.

The main study that started in autumn 1998 is designed as a matched case control study with controls matched for age, gender and location. The expected number of SIDS cases during the data collection period is 600, 1800 controls will be drawn randomly from the local vital registration office. Information from an extensive interview of parents of cases and controls will be linked with medical histories obtained from family physicians and hospital records. All SIDS cases will be autopsied using a standard protocol with external quality control, including investigations for viral respiratory tract and bowel infections. Furthermore cotinin concentrations in hair and body fluids will be determined in order to ascertain exposure to tobacco smoke.

Social support for families of SIDS children will be provided throughout the study period by social workers of the study center closely co-operating with parental self help groups.

The main study will be supplemented by death scene investigations to be carried out in four of the thirteen regions. Moreover, the study aims at producing estimates of the real SIDS incidence in the study area by analyzing death certificates of infants having reportedly died between day 8 and 365 of their lives from all causes comparing this information with that obtained from examined SIDS cases.

The overall goal of this large scale epidemiological investigation of SIDS in Germany which is funded by the Federal Ministry for Research (BMBF) is to contribute to the reduction of infant mortality by defining risk factors for SIDS on which future prevention strategies could be based.