Sudden Infant Death Syndrome: Review for the Obstetric Care Provider

Abstract

Sudden infant death syndrome (SIDS) is the leading cause of death among infants aged 1 to 12 months. In this article, we review risk factors that may predispose infants to increased vulnerability. Maternal characteristics, including nonmodifiable and modifiable factors, antenatal medical conditions, labor and delivery events, and infant characteristics, are reviewed, with the purpose of helping obstetric care providers target risk reduction efforts. We have reviewed over 85 case-control, retrospective, and prospective cohort studies published between 1975 and 2011. Major modifiable risk factors include maternal and paternal smoking, drug use, alcohol use, and insufficient prenatal care. Infants at increased risk include males, premature infants, infants of low birth weight or growth-restricted infants, and infants in multiple gestations. By targeting modifiable and nonmodifiable risk factors, it may be possible to decrease the incidence of SIDS. Efforts should be put on decreasing high-risk behaviors and encouraging sufficient antenatal follow-up. In view of recent increases in ethnic and social disparity with SIDS, it is essential that risk reduction guidelines, which have recently been expanded by the American Association of Pediatrics, be explained in a culturally sensitive manner.

Trends of Social Inequalities in the Specific Causes of Infant Mortality in a Nationwide Birth Cohort in Korea, 1995–2009

“…The major risk factors of SIDS, such as premature birth, LBW, growth-restriction, and a maternal history of multiple gestations, as well as the modifiable factors of SIDS that include such as maternal and paternal smoking, drug use, alcohol use, and insufficient prenatal/postnatal care are found more frequently among infants with parents of a lower social status ( 21 22 ). In particular, environmental sleep factors hazards that include adults sleeping with an infant in the same bed with a shared sleep surface, having infants sleep in the same room as adults, covering an infant's head or face with bedding, prone sleeping, and sleeping without parents or guardians have a social gradient in the same direction as SIDS ( 23 ).…”

Factors influencing the quality of preconception healthcare in China: applying a preconceptional instrument to assess healthcare needs

“…Apart from increased risks of cancer and pulmonary and cardiovascular disease, smoking can also lead to premature birth, sudden infant death, and ectopic pregnancy, and it has implications for the umbilical cord during pregnancy [ 46 ]. Since 1987, lung cancer has outpaced breast cancer as the leading cause of cancer death among women in the world, and exposure to environmental tobacco smoke (ETS) is a cause of lung cancer and coronary heart disease among lifelong nonsmokers.…”

Smoking and Tobacco Use: Ill Effects on Reproductive, Maternal, Newborn, Child Health, and Adolescent (RMNCHA) Program—A Review

“…66 More than one-quarter of the risk of death due to SIDS is attributable to smoking during pregnancy and exposure to SHS, particularly in the home. 67,68 McDonnell-Naughton et al report that the risk of cot death has trebled in infants whose mothers smoke both during and after pregnancy. 69 Postnatal parental smoking is cited as an important risk factor for SIDS.…”