Abstract
A number of socioeconomic and demographic factors are associated with an increased risk ofsudden infant death syndrome (SIDS), but few readily amenable exposure factors have been identified.1 Reports of an association between maternal cigarette smoking during pregnancy and the subsequent occurrence of SIDS, however, do offer the possibility that reducing maternal smoking could result in a decline in the SIDS rate.2-4 Whether the association between SIDS and a history of maternal smoking during pregnancy is biological in nature or a proxy for maternal behavior is not clear. Haglund and Cnattingius reported that infants born to women who smoke during pregnancy die earlier with SIDS than infants of nonsmokers and that a doseresponse association exists between maternal smoking and the risk of SIDS.5 Their report supports the plausibility of a biological mechanism. We attempted to confirm their observations in two large US data sets.
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