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American Journal of Epidemiology Vol. 129, No. 5: 874-884
Copyright © 1989 by The Johns Hopkins University School of Hygiene and Public Health

research-article

INTRAUTERINE GROWTH RETARDATION AND RISK OF SUDDEN INFANT DEATH SYNDROME (SIDS)

GERMAINE M. BUCK1,, DIANE L. COOKFAIR2, ARTHUR M. MICHALEK3, PHILIP C. NASCA4, SUSAN J. STANDFAST5, LOWELL E. SEVER6 and ANDREW A. KRAMER7

1Department of Social and Preventive Medicine, School of Medicine, State University of New York at Buffalo 2211 Main Street, Building A, Buffalo, NY 14214
2Environmental and Occupational Studies Laboratory, Department of Biomathematics, Roswell Park Memorial Institute Buffalo, NY
3Education Department, Roswell Park Memorial Institute Buffalo, NY
4Bureau of Cancer Epidemiology, New York State Health Department Albany, NY
5Department of Injury Control, New York State Health Department Albany, NY
6Division of Birth Defects and Developmental Disabilities, Center for Environment Health and Injury Control, Centers for Disease Control Atlanta, GA
7E. R. Squibb and Sons Princeton, NJ

Send reprint requests to Dr. Germaine M. Buck at this address

The purpose of this study was to assess whether intrauterine growth retardation was associated with an increased risk of sudden infant death syndrome (SIDS). A total of 148 SIDS cases were identified from the Upstate New York (exclusive of New York City) live birth cohort for 1974 (n = 132,948). Dead controls represented all other sudden deaths (n = 114). Live controls were randomly selected and matched to cases on mother's age, race, parity, and residence and infant's birth date (n = 355). Data were collected from vital certificates (response, 97%), medical records (89%), and autopsy reports (100%). Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated with the use of logistic regression techniques to control for confounding. With live controls, significant risks were observed for gestations <37 weeks (OR = 2.2, CI 1.2–4.1), birth weights <2,500 g (OR = 2.5, CI 1.3–5.0) and birth lengths ≤47.0 cm (OR = 3.4, CI 1.8–6.4). Birth length ≤47.0 cm was the only significant risk factor observed when dead controls were used (OR = 2.9, CI 1.3–6.8). Risk decreased with increasing gestation and birth size. Postterm infants (>42 weeks) were at lowest risk (live controls OR = 0.9, CI 0.5–1.6; dead controls OR = 0.6, CI 0.3–1.1). When gestational age was controlled for, SIDS infants were found to have reductions in both weight and length; this suggests that responsible mechanisms begin early in pregnancy.

birth weight; fetal growth retardation; infant, premature; infant, small for gestational age; sudden infant death


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