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a Department of Paediatrics,
Sahlgrenska University Hospital/Östra, Göteborg, Sweden, b Department of
Paediatrics, Karolinska Hospital, Stockholm, Sweden, c Department of Public Health and Primary Health Care,
University of Bergen and Medical Birth Registry of Norway, Bergen,
Norway, d Danish Institute for Clinical
Epidemiology, Copenhagen, Denmark, e Department of Paediatrics, University of Bergen, Norway
Correspondence to: Dr B Alm, Department of Paediatrics, Sahlgrenska University Hospital/Östra, S-416 85 Göteborg, Sweden.
Accepted 10 November
1997
AIM
To establish whether smoking is an independent
risk factor for sudden infant death syndrome (SIDS), if the effect is
mainly due to prenatal or postnatal smoking, and the effect of smoking cessation.
METHODSThe analyses were based on data from the
Nordic epidemiological SIDS study, a case-control study with 244 cases
and 869 controls. Odds ratios were computed by conditional logistic
regression analysis.
RESULTSSmoking emerged as an independent risk
factor for SIDS, and the effect was mainly mediated through maternal
smoking in pregnancy (crude odds ratio 4.0 (95% confidence interval
2.9 to 5.6)). Maternal smoking showed a marked dose-response relation.
There was no effect of paternal smoking if the mother did not smoke.
Stopping or even reducing smoking was beneficial. SIDS cases exposed to
tobacco smoke were breast fed for a shorter time than non-exposed
cases, and feeding difficulties were also more common.
CONCLUSIONSSmoking is an independent risk factor
for SIDS and is mainly mediated through maternal smoking during
pregnancy. Stopping smoking or smoking less may be beneficial in
reducing the risk of SIDS.
This article has been cited by other articles:
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