Changes in the epidemiology of sudden infant death syndrome in Sweden 1973-1996
B Alma, S G Norveniusa, G Wennergrena, R Skjærvenb, N Øyenb, J Mileradc, M Wennborgc, J Kjaerbecka, K Helweg-Larsend, L M Irgensb, on behalf of the Nordic Epidemiological SIDS Study
a Department of
Paediatrics, Institute for the Health of Women and Children, Göteborg
University, The Queen Silvia Children's Hospital, SE-416 85 Göteborg, Sweden, b Medical Birth
Registry, University of Bergen, Bergen, Norway, c Department of
Paediatrics, Karolinska Hospital, Stockholm, Sweden, d Danish
Institute of Clinical Epidemiology, Copenhagen, Denmark
Correspondence to: Dr Alm bernt.alm{at}medfak.gu.se
Accepted 15 June
2000
BACKGROUND
From the early 1970s to
the early 1990s, there was a significant rise in the incidence of
sudden infant death syndrome (SIDS) in Scandinavia. Following the risk
reducing campaign, the incidence has fallen to about the same level as
in 1973.
AIMSTo identify the changes that
have occurred in the epidemiology of SIDS.
METHODSWe compared the Swedish
part of the Nordic Epidemiological SIDS Study (NESS), covering the
years 1992-1995, with two earlier, descriptive studies during this
period. To assess the changing effects of risk factors, we analysed
data from the Medical Birth Registry of Sweden, covering the years
1973-1996.
RESULTSThere was a predominance of
deaths during weekends in the 1970s and 1990s. The seasonal variation
was most notable in the 1980s. The proportion of young mothers
decreased from 14% to 5%. Cohabitation (living with the biological
father) was as frequent in the 1990s as in the 1970s. The prevalence of
high parity, admissions to neonatal wards, low birth weight,
prematurity, and multiple pregnancies were all increased in the 1990s
compared to the 1970s. No significant change in the prevalence of
previous apparent life threatening events was found. Deaths occurring
in cars diminished from 10% to below 2%. In the data from the Medical
Birth Registry of Sweden, there were significantly increased odds
ratios after the risk reducing campaign of the risk factors smoking
during early pregnancy and preterm birth. We could find no increased effects of maternal age, parity, or being small for gestational age
over time. The rate of deaths at weekends remained increased; the
median age at death fell from 90 to 60 days. Seasonal variation was
less notable in the periods of low incidence.
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Keywords: SIDS; epidemiology; Sweden
© 2001 by Archives of Disease in Childhood
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