Combined Effects of Sleeping Position and Prenatal Risk Factors in Sudden Infant Death Syndrome: The Nordic Epidemiological SIDS Study

• Published in: Pediatrics (Evanston) 1997-10, Vol.100 (4), p.613-621
• Main Authors: Oyen, Nina, Markestad, Trond, Rolv Skjarven, Irgens, Lorentz M, Helweg-Larsen, Karin, Alm, Bernt, Norvenius, Gunnar, Wennergren, Goran
• Format: Article
• Language: English
• Subjects: Age Factors; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Case-Control Studies; Emergency and intensive care: neonates and children. Prematurity. Sudden death; Epidemiology; Female; Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi; Health aspects; Health risk assessment; Humans; Infant; Infant, Low Birth Weight; Infant, Newborn; Infant, Premature; Infants; Intensive care medicine; Logistic Models; Low Birth Weight; Male; Medical sciences; Newborn; Odds Ratio; Pediatrics; Pediatrik; Posture; Pregnancy; Pregnancy Complications; Premature; Prenatal development; Prone Position; Public Health, Global Health, Social Medicine and Epidemiology; Risk Factors; Scandinavian and Nordic Countries; SIDS; Sleep; Sleep positions; Sudden Infant Death; Sudden Infant Death - epidemiology; Sudden infant death syndrome
• ISSN: 0031-4005; 1098-4275; 1098-4275
• DOI: 10.1542/peds.100.4.613

Prone sleeping is a strong risk factor for sudden infant death syndrome (SIDS). We investigated whether the combined effect of prone sleeping position and prenatal risk factors further increased the SIDS risk. In the Nordic Epidemiological SIDS Study, parents of SIDS victims in Denmark, Norway, and Sweden completed a questionnaire on potential risk factors for SIDS. Forensic pathologists verified the SIDS diagnosis. Four controls of the same gender, age, and place of birth were selected. This matched case-control study, which included 244 SIDS cases and 869 controls from 1992 to 1995, was analyzed by conditional logistic regression. Odds ratios (ORs) for prone and side sleeping compared with supine sleeping for the last sleep were 13.9 (95% confidence interval 8.2-24) and 3.5 (2.1-5.7). Infants 13 to 24 weeks old had particularly high risk in prone and side sleeping, at 28.5 (7.9-107) and 5.9 (1.6-22). OR for prone sleeping was higher in girls, at 30.4 (11-88), than in boys, 10.3 (5.5-19). We found strong combined effects of sleeping position and prenatal risk factors (more than multiplicative). The OR for prone and side sleeping was increased for infants with birth weight