1. ¹Department of Family Medicine, UMDNJ-RWJMS, New Brunswick, NJ, USA
2. ²Division of Epidemiology, University of Medicine and Dentistry (UMDNJ), School of Public Health, Piscataway, NJ, USA
3. ³Department of Environmental and Community Medicine, University of Medicine and Dentistry (UMDNJ), Robert Wood Johnson Medical School (RWJMS), Piscataway, NJ, USA
4. ⁴Division of Biometrics, University of Medicine and Dentistry of New Jersey (UMDNJ), School of Public Health, New Brunswick, NJ, USA

Correspondence: 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, USA

⁵Dr. Darios Getahun was a postdoctoral primary care health service research fellow when the research was carried out. The fellowship research was supported by the Health Resources and Services Administration (HRSA), T32 PE10011.

Abstract

OBJECTIVES: To compare the incidence and risk factors for sudden infant death syndrome (SIDS) in twin and singleton births and to estimate the concordance of SIDS in twins.

STUDY DESIGN: A cohort analysis using the National Center for Health Statistics Linked Birth and Infant Death files (1995–1998).

RESULTS: Twins had higher SIDS rate (1.3/1000 live births) compared to singletons (0.7/1000 live births), relative risk: 1.9, 95% confidence interval: 1.68, 2.01. Male and small- for-gestational age infants as well as infants of black, unmarried, and smoking mothers were at increased risk for SIDS in both twins and singletons. Placental abnormalities also were associated with SIDS in singletons and twins, although this association failed to achieve statistical significance in twins. There is a higher rate of SIDS in the second twin after a first twin SIDS.

CONCLUSIONS: Twins are at higher risk of SIDS than are singletons. Overall, the epidemiology of SIDS in twins is quite similar to that seen in singletons.