In the Journals

Personalized interventions reduce risk for SIDS

Tailored interventions that target specific components of parents’ behavior can lower the occurrence of sudden infant death syndrome, or SIDS, according to a report recently published in Pediatric Annals.

Fern R. Hauck, MD, MS, and Kawai O. Tanabe, MPH, both of the department of medicine at the University of Virginia School of Medicine, also stated that finding is based on an analysis of previously published studies that gauged the impact of prenatal care, maternal smoking, alcohol and drug use, and childhood vaccinations on SIDS occurrence.

CDC data indicate that in 2015, there were approximately 3,700 sudden unexpected infant deaths in the U.S. Broken down by type in that same year, there were about 1,600 deaths resulting from SIDS, 1,200 deaths due to unknown causes, and 900 deaths resulting from accidental suffocation and strangulation in bed. Previously published reports suggest that in 2015, SIDS deaths had dropped 70% in the past 30 years.

Hauck and Tanabe stated that the SIDS rates have remained stagnant over the past few years, prompting their review.

“This review describes ... factors that are less often addressed and identifies interventions that have resulted in positive behavioral changes that not only benefit infants, but also promote the health and well-being of their mothers,” they wrote.

Among the findings reported by Hauck and Tanabe:

•Maternal binge drinking throughout pregnancy was associated with a 3-fold to 8-fold risk for SIDS in several studies. Cocaine use during pregnancy increased the risk for SIDS 7-fold, and the risk for SIDS was increased 15-fold among children whose mothers were opiate users;

•There was a 50% reduction in risk for SIDS when children had received the diphtheria-pertussis-tetanus vaccine;

•No prenatal care compared with third trimester care almost doubled the risk for SIDS, and infants whose mothers missed more than one antenatal visit also had an increased risk; and

•The pooled RR of studies performed before the ‘Back to Sleep’ campaign (which included recommendations to avoid smoking in pregnancy) was 2.86 (95% CI, 2.77-2.95); after the campaign began it was 3.93 (95% CI, 3.78-4.08). There was an additional increased risk for SIDS when fathers smoked but only if the mothers also smoked.

“Interventions among pregnant mothers should acknowledge individual circumstances and should start prior to becoming pregnant and continue post-pregnancy,” Hauck and Tanabe wrote. “Achieving recommended prenatal care and infant vaccinations, as well as reductions in maternal tobacco and substance use, has the potential to further reduce rates of SIDS and should be given as much attention as safe sleep advice in SIDS risk reduction campaigns.”

Last year, the AAP issued a series of guidelines, such as placing the child in a supine position for every sleep, and placing the child on a firm sleep surface covered by a fitted sheet, that the Academy indicated could minimize SIDS and other sleep-related deaths. Despite these guidelines, other research has suggested not all infants are placed supine for sleep. – by Janel Miller

Reference: “Sudden Unexpected Infant Death Syndrome and Sudden Infant Death Syndrome.” https://www.cdc.gov/sids/data.htm. Accessed Aug. 30, 2017.

Disclosure: The researchers report no relevant disclosures.

Tailored interventions that target specific components of parents’ behavior can lower the occurrence of sudden infant death syndrome, or SIDS, according to a report recently published in Pediatric Annals.

Fern R. Hauck, MD, MS, and Kawai O. Tanabe, MPH, both of the department of medicine at the University of Virginia School of Medicine, also stated that finding is based on an analysis of previously published studies that gauged the impact of prenatal care, maternal smoking, alcohol and drug use, and childhood vaccinations on SIDS occurrence.

CDC data indicate that in 2015, there were approximately 3,700 sudden unexpected infant deaths in the U.S. Broken down by type in that same year, there were about 1,600 deaths resulting from SIDS, 1,200 deaths due to unknown causes, and 900 deaths resulting from accidental suffocation and strangulation in bed. Previously published reports suggest that in 2015, SIDS deaths had dropped 70% in the past 30 years.

Hauck and Tanabe stated that the SIDS rates have remained stagnant over the past few years, prompting their review.

“This review describes ... factors that are less often addressed and identifies interventions that have resulted in positive behavioral changes that not only benefit infants, but also promote the health and well-being of their mothers,” they wrote.

Among the findings reported by Hauck and Tanabe:

•Maternal binge drinking throughout pregnancy was associated with a 3-fold to 8-fold risk for SIDS in several studies. Cocaine use during pregnancy increased the risk for SIDS 7-fold, and the risk for SIDS was increased 15-fold among children whose mothers were opiate users;

•There was a 50% reduction in risk for SIDS when children had received the diphtheria-pertussis-tetanus vaccine;

•No prenatal care compared with third trimester care almost doubled the risk for SIDS, and infants whose mothers missed more than one antenatal visit also had an increased risk; and

•The pooled RR of studies performed before the ‘Back to Sleep’ campaign (which included recommendations to avoid smoking in pregnancy) was 2.86 (95% CI, 2.77-2.95); after the campaign began it was 3.93 (95% CI, 3.78-4.08). There was an additional increased risk for SIDS when fathers smoked but only if the mothers also smoked.

“Interventions among pregnant mothers should acknowledge individual circumstances and should start prior to becoming pregnant and continue post-pregnancy,” Hauck and Tanabe wrote. “Achieving recommended prenatal care and infant vaccinations, as well as reductions in maternal tobacco and substance use, has the potential to further reduce rates of SIDS and should be given as much attention as safe sleep advice in SIDS risk reduction campaigns.”

Last year, the AAP issued a series of guidelines, such as placing the child in a supine position for every sleep, and placing the child on a firm sleep surface covered by a fitted sheet, that the Academy indicated could minimize SIDS and other sleep-related deaths. Despite these guidelines, other research has suggested not all infants are placed supine for sleep. – by Janel Miller

Reference: “Sudden Unexpected Infant Death Syndrome and Sudden Infant Death Syndrome.” https://www.cdc.gov/sids/data.htm. Accessed Aug. 30, 2017.

Disclosure: The researchers report no relevant disclosures.