Kraus J F, Greenland S, Bulterys M
Division of Epidemiology, School of Public Health, UCLA 90024-1772.
Int J Epidemiol. 1989 Mar;18(1):113-20. doi: 10.1093/ije/18.1.113.
Risk factors for sudden infant death syndrome (SIDS) were studied among infants born to the nearly 56,000 women enrolled in the US Collaborative Perinatal Project from 1959 through 1966. The 193 SIDS cases identified in the cohort were compared with 1930 controls randomly selected from infants who survived the first year of life. The previously documented excess risk associated with black race disappeared after adjusting for maternal education and family income. Maternal smoking, maternal anaemia during pregnancy, and lack of early prenatal care were all positively associated with SIDS. After adjustment for gestational age, infants with low weight and length at birth were still at increased SIDS risk, suggesting that intrauterine growth retardation may be a risk factor. Neurological abnormalities diagnosed before death were associated with SIDS, but much of the association was removed by adjusting for birthweight. The negative association of breastfeeding with SIDS was much reduced upon adjustment by maternal education and birthweight. These findings may have important implications in our understanding of the epidemiology of SIDS.
1959年至1966年间，在美国围产期协作项目登记的近56000名妇女所生婴儿中，对婴儿猝死综合征（SIDS）的风险因素进行了研究。在该队列中确定的193例SIDS病例与从一岁存活婴儿中随机选取的1930名对照进行了比较。在对母亲教育程度和家庭收入进行调整后，先前记录的与黑人种族相关的额外风险消失了。母亲吸烟、孕期贫血以及缺乏早期产前护理均与SIDS呈正相关。在对胎龄进行调整后，出生时体重和身长较低的婴儿SIDS风险仍然增加，这表明宫内生长迟缓可能是一个风险因素。死亡前诊断出的神经学异常与SIDS有关，但通过调整出生体重，大部分关联被消除。在对母亲教育程度和出生体重进行调整后，母乳喂养与SIDS的负相关关系大大减弱。这些发现可能对我们理解SIDS的流行病学具有重要意义。
