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Perinatal
Epidemiological Research Unit, Department of Gynaecology and
Obstetrics, Aarhus University Hospital, DK-8200 Aarhus N, Denmark
Correspondence to: Dr Wisborg email: skejkw{at}aau.dk
Accepted 7 April 2000
AIMS
To study the association
between smoking during pregnancy and sudden infant death syndrome
(SIDS) using prospectively collected data, making it possible to
account for a number of potential confounders.
DESIGN
Prospective follow up study
(n = 24 986).
RESULTS
The overall rate of SIDS
was 0.80 per 1000 live births (n = 20). Children of smokers had more
than three times the risk of SIDS compared with children of non-smokers
(OR = 3.5; 95% CI 1.4-8.7), and the risk of SIDS increased with the
number of cigarettes smoked per day (p < 0.05). Adjustment for
parity, alcohol, and caffeine intake during pregnancy, maternal height
and weight before pregnancy, years of school, occupational status,
marital status, and number of antenatal care visits did not change the
results. Adjustment for mother's age marginally reduced the risk of
SIDS associated with smoking (OR = 3.0; 95% CI 1.2-7.3).
CONCLUSIONS
Given the prospective
nature of the study, the number of deaths is small; however, if our
results reflect a true association between smoking during pregnancy and
SIDS, approximately 30-40% of all cases of SIDS could be avoided if
all pregnant women stopped smoking in a population with 30% pregnant
smokers. Our study adds to earlier evidence for an association between
smoking during pregnancy and SIDS. The strengths of the study are the
possibility to adjust for a number of potential confounders and the
fact that information about smoking habits during pregnancy was
prospectively collected.
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