Klonoff-Cohen H S, Edelstein S L, Lefkowitz E S, Srinivasan I P, Kaegi D, Chang J C, Wiley K J
Department of Family and Preventive Medicine, University of California, San Diego, La Jolla 92093-0607.
JAMA. 1995 Mar 8;273(10):795-8. doi: 10.1001/jama.1995.03520340051035.
To examine the relationship between sudden infant death syndrome (SIDS) and smoking during pregnancy; postnatal tobacco smoke exposure from the mother, father, live-in-adults, and day care providers; and postnatal smoke exposure from breast-feeding.
Case-control study.
Five counties in Southern California.
A total of 200 white, African-American, Hispanic, and Asian parents of infants who died of SIDS between 1989 and 1992 were compared with 200 control parents who delivered healthy infants. Case infants were matched to control infants on the basis of birth hospital, birth date, gender, and race. All information was obtained from a detailed telephone interview and validated with medical records.
Risk of SIDS associated with passive smoking by the mother, father, live-in adults, and day care providers; smoking in the same room as the infant; total number of cigarettes smoked by all adults; and maternal smoking during the time period of breast-feeding.
Conditional logistic regression resulted in overall adjusted odds ratios (ORs) for SIDS associated with passive smoke from the mother of 2.28, the father of 3.46, other live-in adults of 2.18, and all sources of 3.50 (95% confidence interval, 1.81 to 6.75), while simultaneously adjusting for birth weight, sleep position, prenatal care, medical conditions at birth, breast-feeding, and maternal smoking during pregnancy. A dose-response effect was noted for SIDS associated with increasing numbers of cigarettes, as well as total number of smokers. Breast-feeding was protective for SIDS among nonsmokers (OR = 0.37) but not smokers (OR = 1.38), when adjusting for potential confounders.
Passive smoking in the same room as the infant increases the risk for SIDS. Physicians should educate new and prospective parents about the risk of tobacco smoke exposure during pregnancy and the first year of the infant's life.
研究婴儿猝死综合征（SIDS）与孕期吸烟、母亲、父亲、同住成年人及日托提供者的产后烟草烟雾暴露以及母乳喂养时的产后烟雾暴露之间的关系。
病例对照研究。
南加利福尼亚的五个县。
将1989年至1992年间死于SIDS的200名白人、非裔美国人、西班牙裔和亚裔婴儿的父母与200名生育健康婴儿的对照父母进行比较。病例婴儿与对照婴儿在出生医院、出生日期、性别和种族方面进行匹配。所有信息均通过详细的电话访谈获得，并经医疗记录验证。
与母亲、父亲、同住成年人及日托提供者的被动吸烟、与婴儿在同一房间吸烟、所有成年人吸烟总数以及母乳喂养期间母亲吸烟相关的SIDS风险。
条件逻辑回归得出，与母亲被动吸烟相关的SIDS总体调整比值比（OR）为2.28，父亲为3.46，其他同住成年人为2.18，所有来源为3.50（95%置信区间，1.81至6.75），同时对出生体重、睡眠姿势、产前护理、出生时的医疗状况、母乳喂养及孕期母亲吸烟进行了调整。发现与香烟数量增加以及吸烟者总数相关的SIDS存在剂量反应效应。在调整潜在混杂因素后，母乳喂养对非吸烟者的SIDS具有保护作用（OR = 0.37），但对吸烟者则不然（OR = 1.38）。
与婴儿在同一房间被动吸烟会增加SIDS风险。医生应就孕期及婴儿出生后第一年烟草烟雾暴露的风险对初为人父母者及准父母进行教育。
