This article is more than 5 years old. Information may no longer be current.
Earlier preterm birth remains linked to increased SUID risk
Despite AAP recommendations for increased safe sleep education in neonatal ICUs, younger gestational age at birth remains associated with elevated rates of sudden unexpected infant death, according to recent study findings.
“The elevated risk [of sudden unexpected infant death] associated with younger gestational age has been attributed to psychologic, social and environmental factors,” Barbara M. Ostfeld, PhD, from the department of pediatrics within the Robert Wood Johnson Medical School at Rutgers University, and colleagues wrote. “For example, some studies have found that preterm infants are more likely to be placed prone and to bed-share, which are major risk factors for SIDS, and that the combination of prematurity and environmental conditions multiplies the risk.”
To observe the relation between gestational age and sudden unexpected infant death (SUID), the researchers examined linked birth and death certificate period files and calculated rates of SUID, ill-defined and unspecified causes, accidental suffocation and strangulation in bed, and overall SUID by gestational age for live births. SUID rates were measured in postneonatal cases, out-of-hospital cases and cases in which an autopsy was conducted.
The researchers then compared survivors and cases of SUID, and computed the associations between gestational age and SUID with estimated logistic regression models.
Infants younger than of 37 weeks’ gestational age were more likely to experience SUID (22.61%) than to survive (10.79%). Rates of SUID varied by gestational age, with higher rates observed at younger gestational ages (2.68 per 1,000 live births for those at 24-27 weeks’ gestational age; 0.51 per 1,000 live births for those at 39-42 weeks’ gestational age).
The logistic regression models assisted in the observation that as SUID risk decreased, gestational age increased. Other factors that were strongly associated with SUID were inadequate prenatal care, smoking during pregnancy and demographics associated with poverty.
“Regardless of whether sleep practices play a role in explaining the observed association between gestational age and SUID in 2012 to 2013, our findings indicate that enhanced recommendations for safe sleep education in the NICU were not sufficient to reduce or eliminate the inverse association between gestational age and SUID or its component causes of death,” Ostfeld and colleagues wrote. The researchers also stress that they are not insinuating that safe sleep guidelines are ineffective for decreasing SUID rates overall or for premature infants.
Disclosure: The researchers provide no relevant financial disclosures.
