Getahun Darios, Amre Devendra, Rhoads George G, Demissie Kitaw
Department of Family Medicine, University of Medicine and Dentistry (UMDNJ)-Robert Wood Johnson Medical School, New Brunswick, New Jersey 08903-0019, USA.
Obstet Gynecol. 2004 Apr;103(4):646-52. doi: 10.1097/01.AOG.0000117081.50852.04.
The objectives of this study were to 1). study the incidence of sudden infant death syndrome (SIDS) among singleton births in the United States and 2). identify maternal and obstetric risk factors for SIDS.
A cohort of all live births in the United States from 1995 to 1998, formed the source population (n = 15627404). The data were obtained from the National Centers for Health Statistics Linked Births and Infant Deaths File. A nested case-control study was used to examine risk factors for SIDS. From this birth cohort, all SIDS deaths (n = 12404) were first identified (case group). From the remaining non-SIDS births, a 4-fold larger sample (n = 49616) was randomly selected as a control group.
The overall incidence of SIDS was 81.7 per 100000 live births. More mothers in the case group than in the control group were reported to have placenta previa (odds ratio [OR]: 1.70; 95% confidence interval [CI] 1.24, 2.33), abruptio placentae (OR 1.57; 95% CI 1.24, 1.98), premature rupture of membranes (OR 1.48; 95% CI 1.33, 1.66), or small for gestational age (OR 1.40; 95% CI 1.30, 1.50 for the 10th percentile). SIDS cases were also more likely to be male. Mothers of cases were more likely to be younger, less educated, and nonwhite, and more of them smoked during pregnancy and did not attend prenatal care.
This analysis confirms the importance of several well known demographic and lifestyle risk factors for SIDS. In addition, placental abnormalities were risk factors for SIDS.
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本研究的目的是：1）研究美国单胎出生婴儿中婴儿猝死综合征（SIDS）的发病率；2）确定SIDS的母体和产科危险因素。
1995年至1998年美国所有活产婴儿组成了源人群（n = 15627404）。数据来自国家卫生统计中心的关联出生与婴儿死亡档案。采用巢式病例对照研究来检查SIDS的危险因素。从这个出生队列中，首先识别出所有SIDS死亡病例（n = 12404）（病例组）。从其余非SIDS出生的婴儿中，随机抽取4倍大的样本（n = 49616）作为对照组。
SIDS的总体发病率为每10万活产81.7例。据报告，病例组中前置胎盘的母亲比对照组更多（比值比[OR]：1.70；95%置信区间[CI] 1.24，2.33），胎盘早剥（OR 1.57；95% CI 1.24，1.98），胎膜早破（OR 1.48；95% CI 1.33，1.66），或小于胎龄（第10百分位数时OR 1.40；95% CI 1.30，1.50）。SIDS病例也更可能为男性。病例组的母亲更可能年轻、受教育程度低、非白人，且她们中更多人在孕期吸烟且未接受产前护理。
本分析证实了几个众所周知的SIDS人口统计学和生活方式危险因素的重要性。此外，胎盘异常是SIDS的危险因素。
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