Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Sudden Infant Death Syndrome among Twin Births: United States, 1995–1998

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.

This is a preview of subscription content, access via your institution

Access options

Buy article

Get time limited or full article access on ReadCube.

$32.00

All prices are NET prices.

References

  1. Beal S . Sudden infant death syndrome in twins. Pediatrics 1989;84:1038–1044.

    CAS  PubMed  Google Scholar 

  2. 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.

    CAS  Article  Google Scholar 

  3. 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.

    CAS  Article  Google Scholar 

  4. Anderson RN, Smith BL . Deaths: leading causes for 2001. Natl Vital Stat Rep 2003;52:1–85.

    PubMed  Google Scholar 

  5. Minino AM, Arias E, Kochanek KD, Murphy SL, Smith BL . Deaths: final data for 2000. Natl Vital Stat Rep 2002;50:1–119.

    PubMed  Google Scholar 

  6. Platt MJ, Pharoah PO . The epidemiology of sudden infant death syndrome. Arch Dis Child 2003;88:27–29.

    CAS  Article  Google Scholar 

  7. 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.

    Article  Google Scholar 

  8. Blatt SD, Meguid V, Church CC . Sudden infant death syndrome and secretin treatment for autism. Curr Opin Pediatr 2000;12:179–183.

    CAS  Article  Google Scholar 

  9. 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.

    CAS  Article  Google Scholar 

  10. Obonai T, Takashima S . In utero brain lesions in SIDS. Pediatr Neurol 1998;19:23–25.

    CAS  Article  Google Scholar 

  11. Reid GM, Tervit H . Sudden infant death syndrome and placental disorders: the thyroid–selenium link. Med Hypotheses 1997;48:317–324.

    CAS  Article  Google Scholar 

  12. 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.

  13. 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.

  14. Stokes ME, Davis CS, Koch GG . Categorical data analysis using the SAS system. Cary, NC: SAS Institute; 2000.

    Google Scholar 

  15. Mathews TJ . Smoking during pregnancy in the 1990s. Natl Vital Stat Rep 2001;49:1–14.

    CAS  PubMed  Google Scholar 

  16. Hofvendahl EA . Smoking in pregnancy as a risk factor for long-term mortality in the offspring. Paediatr Perinat Epidemiol 1995;9:381–390.

    CAS  Article  Google Scholar 

  17. 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.

    CAS  Article  Google Scholar 

  18. Schoendorf KC, Kiely JL . Relationship of sudden infant death syndrome to maternal smoking during and after pregnancy. Pediatrics 1992;90:905–908.

    CAS  PubMed  Google Scholar 

  19. Malloy MH, Freeman Jr DH . Sudden infant death syndrome among twins. Arch Pediatr Adolesc Med 1999;153:736–740.

    CAS  Article  Google Scholar 

  20. Buekens P, Wilcox A . Why do small twins have a lower mortality rate than small singletons? Am J Obstet Gynecol 1993;168:937–941.

    CAS  Article  Google Scholar 

  21. 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.

    CAS  Article  Google Scholar 

  22. 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.

    Article  Google Scholar 

  23. 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.

    CAS  Article  Google Scholar 

  24. 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.

    CAS  Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and Permissions

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

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.jp.7211140

Further reading

Search

Quick links