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.
This is a preview of subscription content, access via your institution
Subscribe to Journal
Get full journal access for 1 year
only $9.92 per issue
All prices are NET prices.
VAT will be added later in the checkout.
Tax calculation will be finalised during checkout.
Get time limited or full article access on ReadCube.
All prices are NET prices.
Beal S . Sudden infant death syndrome in twins. Pediatrics 1989;84:1038–1044.
Koehler SA, Ladham S, Shakir A, Wecht CH . Simultaneous sudden infant death syndrome: a proposed definition and worldwide review of cases. Am J Forensic Med Pathol 2001;22:23–32.
Willinger M, James LS, Catz C . Defining the sudden infant death syndrome (SIDS): deliberations of an expert panel convened by the National Institute of Child Health and Human Development. Pediatr Pathol 1991;11:677–684.
Anderson RN, Smith BL . Deaths: leading causes for 2001. Natl Vital Stat Rep 2003;52:1–85.
Minino AM, Arias E, Kochanek KD, Murphy SL, Smith BL . Deaths: final data for 2000. Natl Vital Stat Rep 2002;50:1–119.
Platt MJ, Pharoah PO . The epidemiology of sudden infant death syndrome. Arch Dis Child 2003;88:27–29.
Getahun D, Amre D, Rhoads GG, Demissie K . Maternal and obstetric risk factors for sudden infant death syndrome (SIDS) in the United States. Obstet Gynecol 2004;103:646–652.
Blatt SD, Meguid V, Church CC . Sudden infant death syndrome and secretin treatment for autism. Curr Opin Pediatr 2000;12:179–183.
Buck GM, Cookfair DL, Michalek AM, Nasca PC, Standfast SJ, Sever LE . Assessment of in utero hypoxia and risk of sudden infant death syndrome. Paediatr Perinat Epidemiol 1989;3:157–173.
Obonai T, Takashima S . In utero brain lesions in SIDS. Pediatr Neurol 1998;19:23–25.
Reid GM, Tervit H . Sudden infant death syndrome and placental disorders: the thyroid–selenium link. Med Hypotheses 1997;48:317–324.
National Center for Health Statistics. 1995–98 Matched Multiple Birth Data Set Hyattsville, MD: U.S. Department of Health and Human Services Centers for Disease Control and Prevention National Center for Health Statistics; 2000.
Centers for Disease Control (U.S.), United States. Health Care Financing Administration., National Center for Health Statistics (U.S.). ICD-9-Cm International Classification of Diseases, Ninth Revision, Clinical Modification, 6th ed. Washington, DC: U.S. Department of Health and Human Services Centers for Disease Control and Prevention Health Care Financing Administration; 1997.
Stokes ME, Davis CS, Koch GG . Categorical data analysis using the SAS system. Cary, NC: SAS Institute; 2000.
Mathews TJ . Smoking during pregnancy in the 1990s. Natl Vital Stat Rep 2001;49:1–14.
Hofvendahl EA . Smoking in pregnancy as a risk factor for long-term mortality in the offspring. Paediatr Perinat Epidemiol 1995;9:381–390.
McMartin KI, Platt MS, Hackman R, et al. Lung tissue concentrations of nicotine in sudden infant death syndrome (SIDS). J Pediatr 2002;140:205–209.
Schoendorf KC, Kiely JL . Relationship of sudden infant death syndrome to maternal smoking during and after pregnancy. Pediatrics 1992;90:905–908.
Malloy MH, Freeman Jr DH . Sudden infant death syndrome among twins. Arch Pediatr Adolesc Med 1999;153:736–740.
Buekens P, Wilcox A . Why do small twins have a lower mortality rate than small singletons? Am J Obstet Gynecol 1993;168:937–941.
Wilcox A, Russell I . Why small black infants have a lower mortality rate than small white infants: the case for population-specific standards for birth weight. J Pediatr 1990;116:7–10.
Joseph K, Liu S, Demissie K, et al. A parsimonious explanation for intersecting perinatal mortality curves: understanding the effect of plurality and of parity. BMC Pregnancy Childbirth 2003;3:3.
Oyen N, Skjaerven R, Little RE, Wilcox AJ . Fetal growth retardation in sudden infant death syndrome (SIDS) babies and their siblings. Am J Epidemiol 1995;142:84–90.
Notzon FC, Bergsjo P, Cole S, Irgens LM, Daltveit AK . International collaborative effort (ICE) on birth weight, plurality, perinatal, and infant mortality. IV. Differences in obstetrical delivery practice: Norway, Scotland and the United States. Acta Obstet Gynecol Scand 1991;70:451–460.
About this article
Cite this article
Getahun, D., Demissie, K., Lu, SE. et al. Sudden Infant Death Syndrome among Twin Births: United States, 1995–1998. J Perinatol 24, 544–551 (2004). https://doi.org/10.1038/sj.jp.7211140
This article is cited by
Nature Reviews Cardiology (2017)
Forensic Science, Medicine, and Pathology (2013)
International Journal of Legal Medicine (2010)
European Journal of Pediatrics (2010)
Journal of Perinatology (2005)