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Archives of Disease in Childhood 1998;79:386-393; doi:10.1136/adc.79.5.386
Copyright © 1998 BMJ Publishing Group Ltd & Royal College of Paediatrics and Child Health.
Arch Dis Child 1998;79:386-393 ( November )

Case-control study of current validity of previously described risk factors for SIDS in the Netherlands

M P l'Hoir,a A C Engelberts,b G Th J van Well,a P Westers,c G J Mellenbergh,d W H G Wolters,a J Hubera

a Psychosocial and Pathology Departments, University Hospital Utrecht/Wilhelmina Children's Hospital, University Hospital for Children and Youth, Utrecht, Netherlands, b University Hospital Leiden, Department of Paediatrics, Leiden, Netherlands, c Centre for Biostatistics, University of Utrecht, Utrecht, Netherlands, d Department of Methodology, Faculty of Psychology, University of Amsterdam, Amsterdam, Netherlands

Correspondence to: Dr l'Hoir, University Hospital Utrecht/Wilhelmina Children's Hospital, PO Box 18009, 3501 CA Utrecht, Netherlands.


Accepted 10 June 1998

This study aimed to assess whether previously established risk factors for sudden infant death syndrome (SIDS) are still valid now that the incidence in the Netherlands has dropped to 0.26 per 1000 liveborn infants. A distinction was made between immutable and mutable risk factors. This case-control study (part of the European Concerted Action on SIDS) comprised 73 SIDS cases and 146 controls and lasted from March 1995 to September 1996. Adjustments were made for sleeping position and bedding factors by treating them as covariables. Apart from these factors, well known risk factors that remain of importance in the Netherlands are: male sex, young maternal age, twins, and low socioeconomic status. These factors are largely immutable. Other well known risk factors which might reflect attitudes to child care and could possibly be mutable are: smoking, alcohol consumption by the mother, bottle feeding, and change of babycare routine. Intervention strategies should focus on early signalling, thereby assisting parents in changing these unfavourable parenting attitudes. Information on optimal child care and extra support by public health nurses specifically aimed at families at risk could help to decrease further the incidence of SIDS in the Netherlands.

Keywords: sudden infant death syndrome; risk factors


© 1998 by Archives of Disease in Childhood

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Male excess in SIDS is not caused by more males sleeping prone than females
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