January 2003
BETHESDA, Md. — A study of Northern Plains Indians found that infants were less likely to die of sudden infant death syndrome (SIDS) if mothers received visits from public health nurses before and after birth, refrained from drinking alcohol during pregnancy and dressed infants in fewer than two layers of clothing while they slept.
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“This study has identified important risk and protective factors for SIDS among this group of American Indians,” said Solomon Iyasu, MBBS, MPH, an epidemiologist with the reproductive health program at the CDC. “Strengthening public health nurse visiting programs and programs to reduce alcohol consumption among women of childbearing age could potentially reduce the high rate of SIDS.”
Infants in homes where a public health nurse had visited before or after birth were 80% less likely to die from SIDS than babies in homes that never had such visits, but the researchers were unable to draw a conclusion about what aspects of the nurse’s visit helped. The Indian Health Service recommends that public health nurses make one prenatal home visit and visits at one and six weeks postpartum.
Binge drinking (five or more drinks at a time) during the mother’s first trimester of pregnancy made it eight times more likely that her infant would die from SIDS. Any maternal alcohol use during the periconceptional period (three months before pregnancy or during the first trimester) was associated with a sixfold increased risk of SIDS.
“The proportion of women who drank in the study declined markedly after the first trimester, indicating that the majority of women stopped drinking once they learned they were pregnant,” said Marian Willinger, PhD, special assistant for SIDS at the National Institute of Child Health and Human Development. “However, there is a risk for SIDS associated with maternal drinking in the period when women may not know they are pregnant.”
Wearing two or more layers of clothing (not including a diaper) increased a baby’s risk for SIDS more than sixfold, the researchers found.
“Parents should dress their babies lightly for sleep and maintain a comfortable room temperature. Overdressing them can result in potentially dangerous overheating,” said Leslie Randall, RN, MPH, an epidemiologist with the CDC and member of the Nez Perce Tribe.
The rate of SIDS among American Indians is the highest of any population group and was slightly more than double that of whites in 1999 — 1.5 SIDS deaths per 1,000 live births compared with 0.7 per 1,000.
The study analyzed 33 SIDS related infant deaths between 1992 and 1996 and 66 control infants, who were matched for postnatal age and community of residence.
For more information:
- Iyasu S, Randall LL, Wetly TK, et al. Risk factors for sudden Infant Death Syndrome among Northern Plains Indians. JAMA. 2002;228(21):2717-23.