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  • Title: A competing risk model of sudden infant death syndrome incidence in two US birth cohorts.
    Author: Pollack HA, Frohna JG.
    Journal: J Pediatr; 2001 May; 138(5):661-7. PubMed ID: 11343040.
    Abstract:
    OBJECTIVES: To compare changing incidence and changing risk factors associated with sudden infant death syndrome (SIDS) in the 1989 and 1996 US birth cohorts. STUDY DESIGN: All available singleton births over 500 g from the 1989 linked birth-infant death file and the 1996 and 1997 Perinatal Mortality files were examined. A log-logistic survival model was used to explicitly account for declining competing risks among low birth weight infants. RESULTS: Controlling for maternal prenatal smoking and other confounders, SIDS incidence declined by >33% between the 2 survey years (adjusted odds ratio = 0.628 with 95% CI [0.598, 0.660]). Self-reported declines in maternal prenatal smoking were also associated with significant declines in SIDS incidence. African American infants and infants born weighing <1000 g experienced increased relative risk compared with non-Hispanic white infants born weighing >2500 g. Hispanic/Latino infants had significantly lower SIDS risk than non-Hispanic white infants in both years. Accounting for declining competing risks and other factors, relative SIDS risks among infants born between 500 and 1000 g increased over the study period. CONCLUSIONS: SIDS incidence sharply declined between 1989 and 1996. High incidence of SIDS in African Americans and increased relative SIDS risk for infants born weighing <1000 g require increased attention from clinicians and public health policy makers.
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