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American Academy of Pediatrics
Article

Maternal Alcohol Use and Sudden Infant Death Syndrome and Infant Mortality Excluding SIDS

Colleen M. O’Leary, Peter J. Jacoby, Anne Bartu, Heather D’Antoine and Carol Bower
Pediatrics March 2013, 131 (3) e770-e778; DOI: https://doi.org/10.1542/peds.2012-1907
Colleen M. O’Leary
aCentre for Population Health Research, Curtin Health Innovation Research Institute, and
bDivision of Population Sciences, Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Perth, Western Australia; and
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Peter J. Jacoby
bDivision of Population Sciences, Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Perth, Western Australia; and
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Anne Bartu
cFaculty of Health Sciences, School of Nursing and Midwifery, Curtin University, Perth, Western Australia;
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Heather D’Antoine
dMenzies School of Health Research, Darwin, Northern Territory, Australia
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Carol Bower
bDivision of Population Sciences, Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Perth, Western Australia; and
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Abstract

BACKGROUND: Improvements in the rate of infant mortality (death in first year of life) have not occurred in recent years. This study investigates the association between maternal alcohol-use disorder and sudden infant death syndrome (SIDS) and infant mortality not classified as SIDS using linked, population-based health and mortality data.

METHODS: Exposed mothers were identified through the presence of an International Classification of Diseases 9/10 alcohol diagnosis, a proxy for alcohol-use disorder, recorded on health, mental health, and/or drug and alcohol datasets (1983–2005). Comparison mothers without an alcohol diagnosis were frequency matched to exposed mothers on maternal age within maternal race and year of birth of their children. All offspring with their birth recorded on the Midwives Notification System compose the exposed (n = 21 841) and comparison (n = 56 054) cohorts. Cases of SIDS (n = 303) and infant mortality excluding SIDS (n = 598) were identified through linkage with the Western Australian Mortality Register. Analyses were conducted by using Cox regression and results presented as adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs).

RESULTS: The highest risk of SIDS occurred when a maternal alcohol diagnosis was recorded during pregnancy (aHR 6.92, 95% CI 4.02–11.90) or within 1 year postpregnancy (aHR 8.61, 95% CI 5.04–14.69). An alcohol diagnosis recorded during pregnancy more than doubled the risk of infant deaths (excluding SIDS) (aHR 2.35, 95% CI 1.45–3.83). Maternal alcohol-use disorder is attributable for at least 16.41% (95% CI 9.73%–23.69%) of SIDS and 3.40% (95% CI 2.28%–4.67%) of infant deaths not classified as SIDS.

CONCLUSIONS: Maternal alcohol-use disorder is a significant risk factor for SIDS and infant mortality excluding SIDS.

KEY WORDS
  • substance abuse/use
  • alcohol and pregnancy
  • sudden infant death syndrome
  • infant mortality
  • cohort
  • epidemiology
  • Abbreviations:
    aHR —
    adjusted hazard ratio
    CI —
    confidence interval
    ICD —
    International Classification of Diseases
    OECD —
    Organisation for Economic Co-operation and Development
    SIDS —
    sudden infant death syndrome
    • Accepted October 25, 2012.
    • Copyright © 2013 by the American Academy of Pediatrics

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    Pediatrics
    Vol. 131, Issue 3
    1 Mar 2013
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    Maternal Alcohol Use and Sudden Infant Death Syndrome and Infant Mortality Excluding SIDS
    Colleen M. O’Leary, Peter J. Jacoby, Anne Bartu, Heather D’Antoine, Carol Bower
    Pediatrics Mar 2013, 131 (3) e770-e778; DOI: 10.1542/peds.2012-1907

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    Maternal Alcohol Use and Sudden Infant Death Syndrome and Infant Mortality Excluding SIDS
    Colleen M. O’Leary, Peter J. Jacoby, Anne Bartu, Heather D’Antoine, Carol Bower
    Pediatrics Mar 2013, 131 (3) e770-e778; DOI: 10.1542/peds.2012-1907
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