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. 2000 Sep;83(3):203–206. doi: 10.1136/adc.83.3.203

A prospective study of smoking during pregnancy and SIDS

K Wisborg 1, U Kesmodel 1, T B Henriksen 1, S F Olsen 1, N J Secher 1
PMCID: PMC1718455  PMID: 10952633

Abstract

AIMS—To study the association between smoking during pregnancy and sudden infant death syndrome (SIDS) using prospectively collected data, making it possible to account for a number of potential confounders.
DESIGN—Prospective follow up study (n = 24 986).
RESULTS—The overall rate of SIDS was 0.80 per 1000 live births (n = 20). Children of smokers had more than three times the risk of SIDS compared with children of non-smokers (OR = 3.5; 95% CI 1.4-8.7), and the risk of SIDS increased with the number of cigarettes smoked per day (p < 0.05). Adjustment for parity, alcohol, and caffeine intake during pregnancy, maternal height and weight before pregnancy, years of school, occupational status, marital status, and number of antenatal care visits did not change the results. Adjustment for mother's age marginally reduced the risk of SIDS associated with smoking (OR = 3.0; 95% CI 1.2-7.3).
CONCLUSIONS—Given the prospective nature of the study, the number of deaths is small; however, if our results reflect a true association between smoking during pregnancy and SIDS, approximately 30-40% of all cases of SIDS could be avoided if all pregnant women stopped smoking in a population with 30% pregnant smokers. Our study adds to earlier evidence for an association between smoking during pregnancy and SIDS. The strengths of the study are the possibility to adjust for a number of potential confounders and the fact that information about smoking habits during pregnancy was prospectively collected.



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Selected References

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  1. Blair P. S., Fleming P. J., Bensley D., Smith I., Bacon C., Taylor E., Berry J., Golding J., Tripp J. Smoking and the sudden infant death syndrome: results from 1993-5 case-control study for confidential inquiry into stillbirths and deaths in infancy. Confidential Enquiry into Stillbirths and Deaths Regional Coordinators and Researchers. BMJ. 1996 Jul 27;313(7051):195–198. doi: 10.1136/bmj.313.7051.195. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Gibbons L. E., Ponsonby A. L., Dwyer T. A comparison of prospective and retrospective responses on sudden infant death syndrome by case and control mothers. Am J Epidemiol. 1993 Mar 15;137(6):654–659. doi: 10.1093/oxfordjournals.aje.a116723. [DOI] [PubMed] [Google Scholar]
  3. Greenland S. Modeling and variable selection in epidemiologic analysis. Am J Public Health. 1989 Mar;79(3):340–349. doi: 10.2105/ajph.79.3.340. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Haglund B., Cnattingius S. Cigarette smoking as a risk factor for sudden infant death syndrome: a population-based study. Am J Public Health. 1990 Jan;80(1):29–32. doi: 10.2105/ajph.80.1.29. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Hiley C. M., Morley C. J. Evaluation of government's campaign to reduce risk of cot death. BMJ. 1994 Sep 17;309(6956):703–704. doi: 10.1136/bmj.309.6956.703. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Holgert H., Hökfelt T., Hertzberg T., Lagercrantz H. Functional and developmental studies of the peripheral arterial chemoreceptors in rat: effects of nicotine and possible relation to sudden infant death syndrome. Proc Natl Acad Sci U S A. 1995 Aug 1;92(16):7575–7579. doi: 10.1073/pnas.92.16.7575. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Krous H. F., Campbell G. A., Fowler M. W., Catron A. C., Farber J. P. Maternal nicotine administration and fetal brain stem damage: a rat model with implications for sudden infant death syndrome. Am J Obstet Gynecol. 1981 Aug 1;140(7):743–746. doi: 10.1016/0002-9378(81)90733-x. [DOI] [PubMed] [Google Scholar]
  8. Lewak N., van den Berg B. J., Beckwith J. B. Sudden infant death syndrome risk factors. Prospective data review. Clin Pediatr (Phila) 1979 Jul;18(7):404–411. doi: 10.1177/000992287901800704. [DOI] [PubMed] [Google Scholar]
  9. Lewis K. W., Bosque E. M. Deficient hypoxia awakening response in infants of smoking mothers: possible relationship to sudden infant death syndrome. J Pediatr. 1995 Nov;127(5):691–699. doi: 10.1016/s0022-3476(95)70155-9. [DOI] [PubMed] [Google Scholar]
  10. Malloy M. H., Hoffman H. J., Peterson D. R. Sudden infant death syndrome and maternal smoking. Am J Public Health. 1992 Oct;82(10):1380–1382. doi: 10.2105/ajph.82.10.1380. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Malloy M. H., Kleinman J. C., Land G. H., Schramm W. F. The association of maternal smoking with age and cause of infant death. Am J Epidemiol. 1988 Jul;128(1):46–55. doi: 10.1093/oxfordjournals.aje.a114957. [DOI] [PubMed] [Google Scholar]
  12. Marshall J. R., Hastrup J. L. Mismeasurement and the resonance of strong confounders: uncorrelated errors. Am J Epidemiol. 1996 May 15;143(10):1069–1078. doi: 10.1093/oxfordjournals.aje.a008671. [DOI] [PubMed] [Google Scholar]
  13. Meny R. G., Carroll J. L., Carbone M. T., Kelly D. H. Cardiorespiratory recordings from infants dying suddenly and unexpectedly at home. Pediatrics. 1994 Jan;93(1):44–49. [PubMed] [Google Scholar]
  14. Mitchell E. A., Ford R. P., Stewart A. W., Taylor B. J., Becroft D. M., Thompson J. M., Scragg R., Hassall I. B., Barry D. M., Allen E. M. Smoking and the sudden infant death syndrome. Pediatrics. 1993 May;91(5):893–896. [PubMed] [Google Scholar]
  15. Oyen N., Markestad T., Skaerven R., Irgens L. M., Helweg-Larsen K., Alm B., Norvenius G., Wennergren G. Combined effects of sleeping position and prenatal risk factors in sudden infant death syndrome: the Nordic Epidemiological SIDS Study. Pediatrics. 1997 Oct;100(4):613–621. doi: 10.1542/peds.100.4.613. [DOI] [PubMed] [Google Scholar]
  16. Ponsonby A. L., Dwyer T., Kasl S. V., Cochrane J. A. The Tasmanian SIDS Case-Control Study: univariable and multivariable risk factor analysis. Paediatr Perinat Epidemiol. 1995 Jul;9(3):256–272. doi: 10.1111/j.1365-3016.1995.tb00141.x. [DOI] [PubMed] [Google Scholar]
  17. Sayers N. M., Drucker D. B., Telford D. R., Morris J. A. Effects of nicotine on bacterial toxins associated with cot death. Arch Dis Child. 1995 Dec;73(6):549–551. doi: 10.1136/adc.73.6.549. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Schellscheidt J., Jorch G., Menke J. Effects of heavy maternal smoking on intrauterine growth patterns in sudden infant death victims and surviving infants. Eur J Pediatr. 1998 Mar;157(3):246–251. doi: 10.1007/s004310050805. [DOI] [PubMed] [Google Scholar]
  19. Schoendorf K. C., Kiely J. L. Relationship of sudden infant death syndrome to maternal smoking during and after pregnancy. Pediatrics. 1992 Dec;90(6):905–908. [PubMed] [Google Scholar]
  20. Walter S. D. Calculation of attributable risks from epidemiological data. Int J Epidemiol. 1978 Jun;7(2):175–182. doi: 10.1093/ije/7.2.175. [DOI] [PubMed] [Google Scholar]
  21. Willinger M. SIDS prevention. Pediatr Ann. 1995 Jul;24(7):358–364. doi: 10.3928/0090-4481-19950701-07. [DOI] [PubMed] [Google Scholar]
  22. Wisborg K., Henriksen T. B., Hedegaard M., Secher N. J. Rygevaner blandt gravide samt sociodemografiske faktorers betydning for rygeophør. Ugeskr Laeger. 1996 Jun 24;158(26):3784–3788. [PubMed] [Google Scholar]
  23. Wisborg K., Henriksen T. B., Hedegaard M., Secher N. J. Smoking habits among Danish pregnant women from 1989 to 1996 in relation to sociodemographic and lifestyle factors. Acta Obstet Gynecol Scand. 1998 Sep;77(8):836–840. [PubMed] [Google Scholar]
  24. Wisborg K., Henriksen T. B., Secher N. J. A prospective intervention study of stopping smoking in pregnancy in a routine antenatal care setting. Br J Obstet Gynaecol. 1998 Nov;105(11):1171–1176. doi: 10.1111/j.1471-0528.1998.tb09970.x. [DOI] [PubMed] [Google Scholar]

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