Are risk factors for sudden infant death syndrome different at night?
S M Williams1, E A Mitchell2
and B J Taylor3
1 Department of Preventive and Social Medicine,
Dunedin School of Medicine, University of Otago, Box 913, Dunedin, New Zealand
2 Department of Paediatrics, University of Auckland, Private Bag ,
Auckland, New Zealand 3 Department of Womens and Childrens Health, Dunedin School of
Medicine, University of Otago, Box 913, Dunedin, New Zealand
Correspondence to:
Ms S M Williams, Department of Preventive and Social Medicine, Dunedin School of
Medicine, University of Otago, Box 913, Dunedin, New Zealand; sheila.williams@stonebow.otago.ac.nz
Aims: To determine whether the risk factors for SIDS
occurringat night were different from those occurring during the
day.
Methods: Large, nationwide case-control study, with data for369 cases and 1558 controls in New Zealand.
Results: Two thirds of SIDS deaths occurred at night (between10 pm and 7 30 am). The odds ratio (95% CI) for prone sleep
position was 3.86 (2.67 to 5.59) for deaths occurring at nightand
7.25 (4.52 to 11.63) for deaths occurring during the day;the
difference was significant. The odds ratio for maternalsmoking for
deaths occurring at night was 2.28 (1.52 to 3.42)and that for the
day 1.27 (0.79 to 2.03); that for the motherbeing single was 2.69
(1.29 to 3.99) for a night time deathand 1.25 (0.76 to 2.04) for a
daytime death. Both interactionswere significant. The interactions
between time of death andbed sharing, not sleeping in a cot or
bassinet, Maori ethnicity,late timing of antenatal care, binge
drinking, cannabis use,and illness in the baby were also
significant, or almost so.All were more strongly associated with
SIDS occurring at night.
Conclusions: Prone sleep position was more strongly associatedwith SIDS occurring during the day, whereas night time deaths
were more strongly associated with maternal smoking and measuresof
social deprivation.
Keywords: SIDS; night; day; prone sleep position; social deprivation;
smoking
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