Mitchell E A, Stewart A W, Scragg R, Ford R P, Taylor B J, Becroft D M, Thompson J M, Hassall I B, Barry D M, Allen E M
Department of Paediatrics, University of Auckland, New Zealand.
BMJ. 1993 Jan 2;306(6869):13-6. doi: 10.1136/bmj.306.6869.13.
To examine the factors which might explain the higher mortality from sudden infant death syndrome in Maori infants (7.4/1000 live births in 1986 compared with 3.6 in non-Maori children).
A large nationwide case control study.
New Zealand. 485 infants who died of sudden infant death syndrome were compared with 1800 control infants. There were 229 Maori and 240 non-Maori cases of sudden infant death syndrome (16 cases unassigned) and 353 Maori and 1410 non-Maori controls (37 unassigned).
Maori infants had 3.81 times the risk (95% confidence interval 3.06 to 4.76) of sudden infant death syndrome compared with non-Maori infants. The risk factors for sudden infant death syndrome within groups were remarkably similar. When Maori and non-Maori controls were compared the prevalence of many of the known risk factors was higher in Maori infants. In particular, mothers were socioeconomically disadvantaged, younger, and more likely to smoke and their infants were of lower birth weight and more likely to share a bed with another person. Multivariate analysis controlling for potential confounders found that simply being Maori increased the risk of sudden infant death syndrome by only 1.37 (95% CI = 0.95 to 2.01), not statistically significantly different from 1. Population attributable risk was calculated for prone sleeping position, maternal smoking, not breast feeding, and infants sharing a bed with another person. In total these four risk factors accounted for 89% of deaths from sudden infant death syndrome in Maori infants and 79% in non-Maori infants.
The high rate of sudden infant death syndrome among Maori infants is based largely on the high prevalence in the Maori population of the major risk factors. Other risk factors, not related to ethnicity, probably explain remaining differences between Maori and non-Maori children.
探究可能解释毛利族婴儿（1986年每1000例活产中有7.4例死于婴儿猝死综合征，而非毛利族儿童为3.6例）婴儿猝死综合征死亡率较高的因素。
一项大规模的全国性病例对照研究。
新西兰。485例死于婴儿猝死综合征的婴儿与1800例对照婴儿进行比较。有229例毛利族和240例非毛利族婴儿猝死综合征病例（16例未分类），以及353例毛利族和1410例非毛利族对照（37例未分类）。
与非毛利族婴儿相比，毛利族婴儿患婴儿猝死综合征的风险是其3.81倍（95%置信区间为3.06至4.76）。各群体中婴儿猝死综合征的风险因素非常相似。当比较毛利族和非毛利族对照时，许多已知风险因素在毛利族婴儿中的患病率更高。特别是，母亲在社会经济方面处于不利地位、更年轻、更可能吸烟，且她们的婴儿出生体重较低，更可能与他人同床。控制潜在混杂因素的多变量分析发现，仅仅是毛利族这一因素使婴儿猝死综合征的风险增加了1.37倍（95%置信区间=0.95至2.01），与1无统计学显著差异。计算了俯卧睡眠姿势、母亲吸烟、非母乳喂养以及婴儿与他人同床这几个因素的人群归因风险。总体而言，这四个风险因素占毛利族婴儿婴儿猝死综合征死亡病例的89%，占非毛利族婴儿的79%。
毛利族婴儿中婴儿猝死综合征的高发生率主要是基于主要风险因素在毛利族人群中的高患病率。其他与种族无关的风险因素可能解释了毛利族和非毛利族儿童之间的剩余差异。
