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© 1990 Oxford University Press

research-article

Timing of Prenatal Care and Risk of Sudden Infant Death Syndrome

GERMAINE M BUCK*, DIANE L COOKFAIR**, ARTHUR M MICHALEK{dagger}, PHILIP C NASCA{ddagger}, SUSAN J STANDFAST§ and LOWELL E SEVER

* Department of Social and Preventive Medicine, School of Medicine and Biomedical Sciences, State University of New York at Buffalo 2211 Main Street, Building A, Buffalo, New York 14214, USA
** Departments of Biomathematics, Roswell Park Memorial Institute 666 Elm Street, Buffalo, New York 14263, USA
{dagger}Department of Education, Roswell Park Memorial Institute 666 Elm Street, Buffalo, New York 14263, USA
{ddagger}Bureau of Cancer Epidemioliogy, New York State Health Department Tower Building, Room 565. Albany, New York 12237. USA
§Injury Control Program, New York State Health Department Tower Building, Room 2202, Albany, New York 12237, USA
Division of Birth Defects and Developmental Disabilities, Center for Environmental Health and Injury Control, Centers for Disease Control F-37, 1600 Clifton Road, North East Atlanta, Georgia 30333, USA

Sudden infant death syndrome (SIDS) is the leading cause of death during post-neonatal life. Mothers whose infants succumb to SIDS are reported to initiate prenatal care later than control mothers. Previous studies have not always controlled for socioeconomic status (SES) of mothers or other potential confounders such as gestational age or birth-weight of infants. The purpose of this study was to assess whether timing of prenatal care adjusted for these potential confounders was an independent risk factor for SIDS. SIDS cases (N = 148) were identified from the Upstate New York livebirth cohort for 1974 (N = 132 948) and compared to randomly selected controls (N = 355) who were frequency-matched on maternal age, race, parity and residence and infant's birth date. Data were abstracted from matched vital certificates (97% response), hospital delivery records (89% response) and selected sample of autopsy reports (100% response). Odds ratios (OR) and 95% confidence intervals (Cl) were obtained using unconditional logistic regression. A significant inverse relationship was observed for number of prenatal visits and risk of SIDS; a significant direct relationship was observed between trimester prenatal care initiated and risk of SIDS. The results suggest that timing of prenatal care is important in assessing SIDS risk even after adjusting for potential confounders of early prenatal care utilization.

Received 1 June 1990


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