Abstract
Sudden infant death syndrome (SIDS), neonatal deaths, and deaths from infection are higher among Indigenous Australians. This study aimed to determine the effects of inflammatory responses and exposure to cigarette smoke, two important factors associated with sudden death in infancy, on preterm birth, and birth weight in a cohort of Indigenous mothers. Indigenous Australian women (n = 131) were recruited as part of a longitudinal study while attending antenatal care clinics during pregnancy; blood samples were collected up to three times in pregnancy. Serum cotinine, indicating exposure to cigarette smoke, was detected in 50.4% of mothers. Compared with non-Indigenous women, the cohort had 10 times the prevalence of antibodies to Helicobacter pylori (33 vs. 3%). Levels of immunoglobulin G, antibodies to H. pylori, and C-reactive protein (CRP) were all inversely correlated with gestational age (P < 0.05). CRP levels were positively associated with maternal body mass index (BMI; ρ = 0.449, P = 0.001). The effects of cigarette smoke (cotinine) and inflammation (CRP) were assessed in relation to risk factors for SIDS: gestational age at delivery and birth weight. Serum cotinine levels were negatively associated with birth weight (ρ = −0.37, P < 0.001), this correlation held true for both male (ρ = −0.39, P = 0.002) and female (ρ = −0.30, P = 0.017) infants. Cotinine was negatively associated with gestational age at delivery (ρ = −0.199, P = 0.023). When assessed by fetal sex, this was significant only for males (ρ = −0.327, P = 0.011). CRP was negatively associated with gestational age at delivery for female infants (ρ = −0.46, P < 0.001). In contrast, maternal BMI was significantly correlated with birth weight. These data highlight the importance of putting programs in place to reduce cigarette smoke exposure in pregnancy and to treat women with chronic infections such as H. pylori to improve pregnancy outcomes and decrease risk factors for sudden death in infancy.
Highlights
Among Indigenous Australians, there is a greater risk of sudden infant death syndrome (SIDS) compared with non-Indigenous Australians [1]
We have previously demonstrated that a central Australian Indigenous community had single nucleotide polymorphisms (SNPs) for cytokine genes that differed significantly from those of non-Indigenous Australians, and this SNP profile might contribute to powerful pro-inflammatory responses implicated in host www.frontiersin.org
We examined the effects of inflammatory responses and exposure to cigarette smoke among a cohort of Indigenous mothers participating in studies of pregnancy outcome on preterm birth and low birth weight, two important factors associated with sudden death in infancy
Summary
Among Indigenous Australians, there is a greater risk of sudden infant death syndrome (SIDS) compared with non-Indigenous Australians [1]. This is perhaps not surprising as low birth weight and preterm birth, both risk factors for SIDS, are approximately twice as common among Indigenous Australians compared with non-Indigenous families [2]. Additional perinatal risk factors for SIDS include poverty and exposure to cigarette smoke [3, 4], factors more common among Indigenous Australians. Indigenous Australian adults, bacterial infections [6]. Either from a “cold,” or an infection of a gastric nature, is often reported by parents of SIDS infants; and the risk factors for SIDS parallel those for infection (see Blackwell et al, this issue)
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