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Published on January 20, 2020

Avera Researchers Publish Major Findings About SIDS Risk

Research published in eClinicalMedicine, an international online clinical journal published by The Lancet, reveals major findings that smoking cigarettes and drinking alcohol during pregnancy significantly increase the risk of sudden infant death syndrome (SIDS).

Amy Elliott, PhD, Chief Clinical Research Officer of the Avera Center for Pediatric and Community Research in Sioux Falls, S.D., is the corresponding and co-first author of the study, along with Hannah Kinney, MD, of Boston Children’s Hospital.

“Our major finding was that if women drink and smoke beyond the first trimester of pregnancy, risk for SIDS goes up by almost 12 times,” Elliott said.

Past studies have looked into the risk caused by smoking alone or drinking alone during pregnancy. This is the first large-scale prospective study to look into the two factors together and the first to consider smoking and drinking throughout the entire pregnancy. “Both behaviors are dangerous to unborn infants but combined the two have a synergistic effect upon risk for SIDS,” Elliott said.

The Safe Passage Study, funded by three National Institutes of Health (NIH) institutes, was a prospective study that followed 10,088 women, 11,892 pregnancies and 12,029 fetuses to one year after delivery. Subjects were from five U.S. sites, including two American Indian Reservations, as well as two sites in Cape Town, South Africa.

A prospective study involves taking a cohort of subjects and watching them for outcomes over a period of time. “This is one of the strongest study designs, looking at what increases risks and potential causes of given outcomes – which in this study were stillbirth and SIDS,” Elliott explained.

The Avera Center for Pediatric and Community Research enrolled approximately 5,500 of the moms early in pregnancy and followed them through the babies’ first year of life.

“The major public health message to come out of this study should be a strong warning against drinking alcohol and/or smoking cigarettes during pregnancy – especially after the first trimester,” Elliott said.

It’s important to recognize that not everyone who drinks and smokes during pregnancy will lose their child to SIDS. “These are risk factors. If you want to do everything you can to reduce the chance of SIDS, taking care of yourself during pregnancy is one of the best ways to do that,” Elliott said.

The study also should not be construed to mean that every mother whose baby dies of SIDS drank and/or smoked during pregnancy. “There are multiple factors that contribute to SIDS deaths, and sometimes these deaths are entirely unexplained,” Elliott said. “Any unexpected death of an infant is a family tragedy. We grieve and mourn with parents who have lost children to SIDS.”

There are 3.5 million live births per year in the United States, and approximately 2,500 infants die of SIDS each year.

Sometimes, SIDS cannot be prevented, but there are ways to lessen the risk:

  • Do not drink or smoke during pregnancy
  • Place your baby to sleep on their back in their own crib or bassinet
  • Use a firm mattress and avoid placing thick bedding, pillows or fluffy toys in the crib
  • Breastfeed your baby if possible
  • Don’t allow your baby to become overheated
  • Have your baby sleep in your room for the first year, alone in a separate crib or bassinet and not in bed with you

“Because it’s such a tragedy, to be able to reduce the risk for an outcome like SIDS is huge. Luckily SIDS is a rare outcome, yet when it does occur, it is heartbreaking,” Elliott said.

The Avera Center for Pediatric and Community Research has locations in Sioux Falls, Rapid City and Pine Ridge, S.D. This research team of 26 works to understand factors that determine the health of a certain population, and how to improve it. It conducts studies that will help answer crucial questions about the effects that physical, chemical, biological, social and behavioral environments have on the health of children.

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