Black L, David R J, Brouillette R T, Hunt C E
J Pediatr. 1986 Feb;108(2):209-14. doi: 10.1016/s0022-3476(86)80984-2.
Sudden infant death syndrome occurs with increased frequency in low birth weight infants and in black infants. The degree to which the higher LBW rate among blacks might explain this higher SIDS rate is unknown. To address this question, we analyzed the 1233 SIDS deaths that occurred among 252,376 neonatal survivors in Cook County from 1975 to 1980, using computer-coded matched infant birth and death records. Birth weight and ethnic group were identified. The overall SIDS rates in blacks, Hispanics, and whites were 5.1, 1.2, and 1.3/1000 neonatal survivors, respectively. Within each ethnic group, the SIDS rates increased progressively with decreasing birth weight. Within the less than or equal to 1500 gm birth weight groups, the SIDS rates were 16.4, 3.9, and 5.5/1000 neonatal survivors in blacks, Hispanics, and whites. Using direct standardization, we found that 27% of the SIDS rate disparity between blacks and whites could be explained by the higher LBW rate in blacks (14% vs 6% in whites). The good outcomes in both LBW and SIDS rates for the Hispanic population were unexpected because, like blacks, Hispanics are socioeconomically disadvantaged. Findings for this group suggest that the remaining 73% of the increased SIDS rate in blacks cannot be attributed in a straightforward manner to differences in income or educational attainment.
低体重婴儿和黑人婴儿中，婴儿猝死综合征的发生率较高。黑人中较高的低体重率在多大程度上可以解释这种较高的婴儿猝死综合征发生率尚不清楚。为了解决这个问题，我们利用计算机编码的婴儿出生和死亡匹配记录，分析了1975年至1980年库克县252376名新生儿幸存者中发生的1233例婴儿猝死综合征死亡病例。确定了出生体重和种族。黑人、西班牙裔和白人的婴儿猝死综合征总体发生率分别为5.1/1000、1.2/1000和1.3/1000新生儿幸存者。在每个种族群体中，婴儿猝死综合征发生率随着出生体重的降低而逐渐增加。在出生体重小于或等于1500克的组中，黑人、西班牙裔和白人的婴儿猝死综合征发生率分别为16.4/1000、3.9/1000和5.5/1000新生儿幸存者。通过直接标准化，我们发现黑人与白人之间婴儿猝死综合征发生率差异的27%可以由黑人中较高的低体重率来解释（黑人中为14%，白人中为6%）。西班牙裔人群在低体重率和婴儿猝死综合征发生率方面的良好结果出乎意料，因为与黑人一样，西班牙裔在社会经济方面处于不利地位。该群体的研究结果表明，黑人中婴儿猝死综合征发生率增加的其余73%不能直接归因于收入或教育程度的差异。
