ORIGINAL ARTICLE

Are risk factors for sudden infant death syndrome different at night?

S M Williams¹, E A Mitchell², B J Taylor³

¹ Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Box 913, Dunedin, New Zealand
² Department of Paediatrics, University of Auckland, Private Bag , Auckland, New Zealand
³ Department of Women’s and Children’s Health, Dunedin School of Medicine, University of Otago, Box 913, Dunedin, New Zealand

Correspondence to:
Correspondence to:
Ms S M Williams, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Box 913, Dunedin, New Zealand;
sheila.williams{at}stonebow.otago.ac.nz

Aims: To determine whether the risk factors for SIDS occurring at night were different from those occurring during the day.

Methods: Large, nationwide case-control study, with data for 369 cases and 1558 controls in New Zealand.

Results: Two thirds of SIDS deaths occurred at night (between 10 pm and 7 30 am). The odds ratio (95% CI) for prone sleep position was 3.86 (2.67 to 5.59) for deaths occurring at night and 7.25 (4.52 to 11.63) for deaths occurring during the day; the difference was significant. The odds ratio for maternal smoking for deaths occurring at night was 2.28 (1.52 to 3.42) and that for the day 1.27 (0.79 to 2.03); that for the mother being single was 2.69 (1.29 to 3.99) for a night time death and 1.25 (0.76 to 2.04) for a daytime death. Both interactions were significant. The interactions between time of death and bed sharing, not sleeping in a cot or bassinet, Maori ethnicity, late timing of antenatal care, binge drinking, cannabis use, and illness in the baby were also significant, or almost so. All were more strongly associated with SIDS occurring at night.

Conclusions: Prone sleep position was more strongly associated with SIDS occurring during the day, whereas night time deaths were more strongly associated with maternal smoking and measures of social deprivation.

Keywords: SIDS; night; day; prone sleep position; social deprivation; smoking

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