Birth weight- and gestational age-specific sudden infant death syndrome mortality: United States, 1991 versus 1995.

OBJECTIVE To estimate the changes in birth weight- and gestational age-specific sudden infant death syndrome (SIDS) mortality rates since the publication of the sleep-positioning recommendations by the American Academy of Pediatrics Task Force on Infant Positioning and SIDS. METHODS This is a historical cohort study using US vital statistic linked birth and infant death certificate files for the years 1991 and 1995. SIDS deaths were identified as any death attributed to International Classification of Diseases, Ninth Revision code 7980, occurring between the 28th and 365th days of life. RESULTS There were 4871 deaths attributed to SIDS in 1991 for a postneonatal mortality rate of 1.2/1000 postneonatal survivors compared with 3114 deaths in 1995 for a rate of.8/1000. This represents a 33% drop in the postneonatal SIDS mortality from 1991 to 1995. Between 1991 and 1995, SIDS rates declined 38%, 38%, 35%, and 32% for birth weight groupings of 500 to 999 g, 1000 to 1499 g, 1500 to 2499 g, and >/=2500 g, respectively. There were no SIDS deaths attributed to infants weighing <500 g. The SIDS rates declined 27%, 21%, 40%, and 23% for gestational age groups of <29 weeks, 29 to 32 weeks, 33 to 36 weeks, and >/=37 weeks. The rate of decline did not differ significantly across birth weight- or gestational age-specific categories. There was a significant increase in the black:non-black postneonatal SIDS mortality ratio from 2.00 to 2.28, reflecting a smaller decline in birth weight- and gestational age-specific mortality for blacks than observed for the non-black population. CONCLUSION Postneonatal SIDS mortality decreased significantly across all broad birth weight and gestational age categories. If the decline in the prevalence of prone positioning that has been reported since 1992 has occurred across all birth weight and gestational age, these data support the hypothesis that supine or side sleep positioning is effective in preterm/low birth weight infants as well as term infants.

[1]  S. Beal,et al.  Sudden Infant Death Syndrome Related to Climate , 1991, Acta paediatrica Scandinavica.

[2]  C. McEvoy,et al.  Prone positioning decreases episodes of hypoxemia in extremely low birth weight infants (1000 grams or less) with chronic lung disease. , 1997, The Journal of pediatrics.

[3]  M. Mirmiran,et al.  More awakenings and heart rate variability during supine sleep in preterm infants. , 1999, Pediatrics.

[4]  M. J. Wagaman,et al.  Improved oxygenation and lung compliance with prone positioning of neonates. , 1979, The Journal of pediatrics.

[5]  N. Mcglashan.  Sudden infant deaths in Tasmania, 1980-1986: a seven year prospective study. , 1989, Social science & medicine.

[6]  J. Groswasser,et al.  Prone or supine body position and sleep characteristics in infants. , 1993, Pediatrics.

[7]  H. Lagercrantz,et al.  The decline in the incidence of SIDS in Scandinavia and its relation to risk‐intervention campaigns , 1997, Acta paediatrica.

[8]  E. Mitchell,et al.  Reduction in mortality from sudden infant death syndrome in New Zealand: 1986-92. , 1994, Archives of disease in childhood.

[9]  K. Neuber,et al.  Arterial oxygen saturation in infants at risk of sudden death: influence of sleeping position , 1995, Acta paediatrica.

[10]  J. Groswasser,et al.  Auditory arousal thresholds are higher when infants sleep in the prone position. , 1998, The Journal of pediatrics.

[11]  Aap Task Force on Infant Positioning and Sids.  Positioning and SIDS , 1992, Pediatrics.

[12]  H. Hoffman,et al.  Infant sleep position and risk for sudden infant death syndrome: report of meeting held January 13 and 14, 1994, National Institutes of Health, Bethesda, MD. , 1994, Pediatrics.

[13]  S. Mckenzie,et al.  Transcutaneous oxygen saturation in sleeping infants: prone and supine. , 1990, Archives of disease in childhood.

[14]  H. Hoffman,et al.  Epidemiology of the sudden infant death syndrome: maternal, neonatal, and postneonatal risk factors. , 1992, Clinics in perinatology.

[15]  J. Kattwinkel,et al.  Infant sleep position and sudden infant death syndrome (SIDS) in the United States: joint commentary from the American Academy of Pediatrics and selected agencies of the Federal Government. , 1994, Pediatrics.

[16]  D. P. Davies,et al.  Sudden infant death syndrome in Hong Kong: confirmation of low incidence. , 1989, BMJ.

[17]  R. Kessler,et al.  Factors associated with the transition to nonprone sleep positions of infants in the United States: the National Infant Sleep Position Study. , 1998, JAMA.

[18]  T. Dwyer,et al.  The contribution of changes in the prevalence of prone sleeping position to the decline in sudden infant death syndrome in Tasmania. , 1995, JAMA.

[19]  T. Dwyer,et al.  Prospective cohort study of prone sleeping position and sudden infant death syndrome , 1991, The Lancet.

[20]  E. Mitchell,et al.  Results from the first year of the New Zealand cot death study. , 1991, The New Zealand medical journal.