Oyen N, Skjaerven R, Irgens L M
Medical Birth Registry of Norway, University of Bergen.
Am J Epidemiol. 1996 Aug 1;144(3):300-5. doi: 10.1093/oxfordjournals.aje.a008925.
To investigate the recurrence of sudden infant death syndrome (SIDS) among siblings, the authors analyzed data for all 352,475 mothers whose first and second single births were reported to the Medical Birth Registry of Norway during 1967-1988. Recurrence of stillbirths from the 16th week of gestation onward and infant deaths other than SIDS were also studied. Relative risk of recurrence for SIDS was 5.8 (95% confidence interval (CI) 2.1-13.2); for asphyxia- and immaturity-related infant deaths, 12.5 (9.2-17.4); for congenital malformations, 7.2 (4.7-11.0); and for other causes of infant death, 8.0 (2.0-22.1). Deaths due to infections did not recur. Similar categories of infant deaths had higher overall relative risk, 9.1, compared with 1.6 for dissimilar categories. Previous early stillbirth (16-27 weeks) had a high recurrence (relative risk (RR) = 21.8, 95% CI 17.5-26.9), while late stillbirth (> or = 28 weeks) had lower recurrence (RR = 4.6, 95% CI 3.7-5.8). Previous SIDS was associated with an increased risk of all other types of loss. In contrast, previous late stillbirth and previous asphyxia- and immaturity-related infant deaths were associated with a reduced risk of subsequent SIDS (RR = 0.31, 95% CI 0.08-0.84, and RR = 0.23, 95% CI 0.01-1.13, respectively). In conclusion, as with other infant and fetal deaths, SIDS deaths showed strong sibship aggregation consistent with a genetic susceptibility in subsets of SIDS that may interact with environmental factors. The authors also suggest common pregnancy-specific risk factors for late stillbirths, asphyxia- and immaturity-related infant deaths, and SIDS.
为了研究婴儿猝死综合征（SIDS）在兄弟姐妹中的复发情况，作者分析了1967年至1988年期间向挪威医疗出生登记处报告的所有352,475名头胎和二胎单胎母亲的数据。还研究了从妊娠第16周起的死产复发情况以及除SIDS之外的婴儿死亡情况。SIDS复发的相对风险为5.8（95%置信区间（CI）2.1 - 13.2）；窒息和不成熟相关的婴儿死亡为12.5（9.2 - 17.4）；先天性畸形为7.2（4.7 - 11.0）；其他婴儿死亡原因的相对风险为8.0（2.0 - 22.1）。感染导致的死亡没有复发。与不同类别相比，相似类别的婴儿死亡总体相对风险更高，为9.1，而不同类别为1.6。既往早期死产（16 - 27周）复发率较高（相对风险（RR）= 21.8，95% CI 17.5 - 26.9），而晚期死产（≥28周）复发率较低（RR = 4.6，95% CI 3.7 - 5.8）。既往SIDS与所有其他类型的死亡风险增加相关。相比之下，既往晚期死产以及既往窒息和不成熟相关的婴儿死亡与随后SIDS的风险降低相关（RR分别为0.31，95% CI 0.08 - 0.84和RR = 0.23，95% CI 0.01 - 1.13）。总之，与其他婴儿和胎儿死亡一样，SIDS死亡显示出强烈的同胞聚集性，这与SIDS亚组中可能与环境因素相互作用的遗传易感性一致。作者还提出了晚期死产、窒息和不成熟相关的婴儿死亡以及SIDS常见的特定妊娠风险因素。
