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Consider absolute risks in SIDS prevention
  1. Department of Paediatric Epidemiology
  2. Institute of Child Health, 30 Guilford Street
  3. London WC1N 1EH, UK
  4. email:
  5. St George's Hospital, Blackshaw Road
  6. London SW17 0QT, UK

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Editor,—The demonstration by Blairet al of an association between poor postnatal growth and an increased risk of sudden infant death syndrome (SIDS),1 is a useful addition to our understanding of the aetiology of this condition. It is unfortunate that the conclusion in the abstract that “Poor postnatal weight gain was independently associated with an increased risk of SIDS and could be identified at the routine six week assessment” goes beyond the data presented.

It can be estimated from the data in this study that the overall risk of SIDS was 0.77/1000 live births. The risk in babies with birth weights greater than the 15th centile, the group in whom the relation with postnatal growth was detected, was 0.68/1000. Given the reported odds ratio of 1.75 associated with being in the slowest growing 16% who might be identified at six weeks, the data suggest that the absolute risk of SIDS among this group would be about 1.1/1000. Even a programme targeted at infants below the 2nd centile for growth at six weeks, would identify a group whose absolute risk of SIDS was about 4.2/1000—that is, for every infant who might …

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