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Title: Birth Weight- and Gestational Age-Specific Sudden Infant Death
Syndrome Mortality: United States, 1991 Versus 1995.
Authors: Malloy M, Freeman D.
Source: Pediatrics 2000; 105:1227-31.
Reviewed by: Lawrence Rasouliyan, MPH, American SIDS Institute




Since 1989, a more pronounced decrease in the incidence of SIDS has been observed than in previous years. For instance, between years 1991 and 1995, overall postneonatal SIDS mortality decreased from 1.30 to 0.87 deaths per 1000 live births. This decrease, however, represents an
overall trend applied to all infants; and from these data, one cannot determine whether the drop in the incidence of SIDS is common to infants across birth weight and gestational age classifications.The objective of this study was to determine if the observed decrease in SIDS mortality was shared for infants among different strata of birth weight and gestational age.

In this study, the investigators utilized linked birth and infant death certificate data from the United States vital statistics files for years 1991 and 1995. The incidence of SIDS was compared for the two years across different birth weight and gestational age groups.

The authors found that gestational age-specific and birth weight-specific SIDS rates between 1991 and 1995 decreased for infants in each category, all of which attained statistical significance. When percent decline in each of these categories was compared to one another, little difference was observed across birth weight and gestational age groups. This conclusion was also applicable to blacks and non-blacks when the data were stratified by race.

These data demonstrate that the incidence of SIDS decreased across all gestational age and birth weight categories from 1991 to 1995. The investigators hypothesized that "if the decline in the prevalence of prone positioning that has been reported since 1992 has occurred across all birth weight and gestational age, these data support the hypothesis that supine or side sleep positioning is effective in preterm/low birth weight infants as well as term infants." [The authors noted that they have no direct evidence of an association with infant sleep position in this study because infant sleep position was not listed on the birth certificates].


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