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Archives of Disease in Childhood 2000;82:462-469; doi:10.1136/adc.82.6.462
Copyright © 2000 BMJ Publishing Group Ltd & Royal College of Paediatrics and Child Health.
Arch Dis Child 2000;82:462-469 ( June )

Article

Weight gain and sudden infant death syndrome: changes in weight z scores may identify infants at increased risk Peter S Blaira, Pam Nadina, Tim J Coled, Peter J Fleminga, Iain J Smithb, Martin Ward Plattc, P J Berrya, Jean Goldinga, and the CESDI SUDI research group

a FSID Unit, Dept of Child Health, Royal Hospital for Children, St Michael's Hill, Bristol BS2 8BJ, UK, b Nuffield Institute for Health, 71-75 Clarendon Road, Leeds LS2 9PL, UK, c Newcastle Neonatal Service, Ward 35, Royal Victoria Infirmary, Newcastle-upon-Tyne NE1 4LP, UK, d Department of Epidemiology and Public Health, Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK

Correspondence to: Dr Blair email: p.s.blair{at}bris.ac.uk

Accepted 15 February 2000

AIMS---To investigate patterns of infant growth that may influence the risk of sudden infant death syndrome (SIDS).
DESIGN---Three year population based case control study with parental interviews for each death and four age matched controls. Growth was measured from prospective weight observations using the British 1990 Growth Reference.
SETTING---Five regions in England (population greater than 17 million, more than 470 000 live births over three years).
SUBJECTS---247 SIDS cases and 1110 controls.
RESULTS---The growth rate from birth to the final weight observation was significantly poorer among the SIDS infants despite controlling for potential confounders (SIDS mean change in weight z score (delta zw) = -0.38 (SD 1.40) v controls = +0.22 (SD 1.10), multivariate: p < 0.0001). Weight gain was poorer among SIDS infants with a normal birth weight (above the 16th centile: odds ratio (OR) = 1.75, 95% confidence interval (CI) 1.48-2.07, p < 0.0001) than for those with lower birth weight (OR = 1.09, 95% CI 0.61-1.95, p = 0.76). There was no evidence of increased growth retardation before death.
CONCLUSIONS---Poor postnatal weight gain was independently associated with an increased risk of SIDS and could be identified at the routine six week assessment.


Key messages

  • The lower weight of SIDS infants compared to the control infants which was apparent at birth was even more notable in the two weeks before death
  • SIDS infants, particularly those of normal birth weight, exhibited poorer weight gain than their controls
  • Although poor growth was evident among SIDS infants there was no evidence of accelerated retardation in the weeks prior to death
  • The difference in growth between SIDS and control infants was apparent within the first five to seven weeks of life




Keywords: SIDS; weight gain; z scores; conditional growth charts

© 2000 by Archives of Disease in Childhood
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eLetters:

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Consider absolute risks in SIDS prevention
Stuart Logan, et al.
ADC Online, 26 Jun 2000 [Full text]
Re: Consider absolute risks in SIDS prevention
Peter Blair
ADC Online, 7 Jul 2000 [Full text]

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