Abstract
The effect of altitude on the risk of sudden infant death syndrome (SIDS) has been reported previously, but with conflicting findings. We aimed to examine whether the risk of sudden unexpected infant death (SUID) varies with altitude in the United States. Data from the Centers for Disease Control and Prevention (CDC)’s Cohort Linked Birth/Infant Death Data Set for births between 2005 and 2010 were examined. County of birth was used to estimate altitude. Logistic regression and Generalized Additive Model (GAM) were used, adjusting for year, mother’s race, Hispanic origin, marital status, age, education and smoking, father’s age and race, number of prenatal visits, plurality, live birth order, and infant’s sex, birthweight and gestation. There were 25,305,778 live births over the 6-year study period. The total number of deaths from SUID in this period were 23,673 (rate = 0.94/1000 live births). In the logistic regression model there was a small, but statistically significant, increased risk of SUID associated with birth at > 8000 feet compared with < 6000 feet (aOR = 1.93; 95% CI 1.00–3.71). The GAM showed a similar increased risk over 8000 feet, but this was not statistically significant. Only 9245 (0.037%) of mothers gave birth at > 8000 feet during the study period and 10 deaths (0.042%) were attributed to SUID. The number of SUID deaths at this altitude in the United States is very small (10 deaths in 6 years).
Highlights
The effect of altitude on the risk of sudden infant death syndrome (SIDS) has been reported previously, but with conflicting findings
The aim of this study was to examine whether the risk of sudden unexpected infant death (SUID) varies with altitude in the U.S We hypothesised that increasing altitude would be associated with an increased risk of SUID
9245 (0.037%) of mothers gave birth at > 8000 feet. Over these 6 years there were only 10 SUID cases that occurred over 8000 feet
Summary
The effect of altitude on the risk of sudden infant death syndrome (SIDS) has been reported previously, but with conflicting findings. We aimed to examine whether the risk of sudden unexpected infant death (SUID) varies with altitude in the United States. Abbreviations CDC Centers for Disease Control and Prevention CI Confidence interval GAM Generalized additive model ICD-10 International Classification of Diseases, 10th Revision aOR Adjusted odds ratio SIDS Sudden infant death syndrome SUID Sudden unexpected infant death U.S United States. Case–control studies, those in the late 1980s and early 1990s, identified several infant care practices associated with sudden infant death that were potentially modifiable These included prone sleep position, smoking, bed sharing and the protective effect of room sharing, pacifier use and breastfeeding. The effect of altitude on the risk of SIDS has been studied previously, but with conflicting findings
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