Abstract
Maternal smoking has long been identified as a risk factor for SIDS. However, almost all data available are based on information obtained after SIDS had occurred and are, therefore, potentially influenced by recall bias. In Lower Saxony, detailed information concerning the perinatal period, including information on the number of cigarettes smoked during pregnancy, is routinely obtained for almost all infants born in this region. The neonatal data sets from 190 SIDS cases who had died between 1985 and 1990 and in whom a full post-mortem had been performed were identified and compared to the data sets from 5920 random controls, frequency-matched for year of birth.
After adjustment for potential confounders (social class, birthweight, maternal age, ethnicity), smoking during pregnancy was still associated with a significantly increased risk of SIDS (odds ratio(OR) 2.7, 95% CI 1.7-4.5). There was a clear dose-effect relationship between the number of cigarettes smoked during pregnancy and the risk of SIDS: Adjusted ORs were 2.6 (1.5-4.4) for 1-10 cigarettes/day, 2.8 (1.8-6.0) for 11-20cigarettes/day. and 6.9(1.9-25.5) for >20 cigarettes/day.
These results confirm previous studies that maternal smoking is one of the most important amongst the potentially amenable risk factors for SIDS. The fact that the ORs found in this study, particularly for heavy smoking (>1 pack/day), were even higher than those observed previously, suggest that the true importance of this risk factor may be understimated if data are obtained only after an infant has died of SIDS.
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Poets, C., Rudolph, A., Schlaud, M. et al. 356 MATERNAL CIGARETTE SMOKING AND SUDDEN INFANT DEATH SYNDROME (SIDS) RESULTS FROM THE LOWER SAXONY PERINATAL PROJECT. Pediatr Res 36, 62 (1994). https://doi.org/10.1203/00006450-199407000-00356
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DOI: https://doi.org/10.1203/00006450-199407000-00356