ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1992.tb02723.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1992.tb02726.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractNew Zealand's high mortality rate from sudden infant death syndrome (SIDS) prompted the development of the New Zealand Cot Death Study. A report of the analysis of the data from the first year has been published. This report now gives the major identified risk factors from the full 3 year data set. In this case‐control study there were 485 infants who died from SIDS in the post‐neonatal age group, and 1800 control infants, who were a representative sample of all hospital births in the study region. Obstetric records were examined and parental interviews were completed in 97.5% and 86.9% of subjects, respectively. As expected many risk factors for SIDS were confirmed including: lower socio‐economic status, unmarried mother, young mother, younger school‐leaving age of mother, younger age of mother at first pregnancy, late attendance at antenatal clinic, non‐attendance at antenatal classes, Maori, greater number of previous pregnancies, the further south the domicile, winter, low birthweight, short gestation, male infant and admission to a special care baby unit. In addition, however, we identified four risk factors that are potentially amenable to modification. These were the prone sleeping position of the baby (odds ratio (OR) = 3.70; 95% confidence interval (Cl) = 2.91, 4.70); bed sharing (OR = 2.70; 95% Cl = 2.02, 3.62); maternal smoking of 1–9 cigarettes per day (OR = 3.47; 95% Cl = 2.50, 4.83), 10–19 cigarettes per day (OR = 3.94; 95% Cl = 2.87, 5.41) or more than 20 cigarettes per day (OR = 5.90; 95% Cl = 4.20, 8.31); and not breast feeding (OR = 2.39; 95% Cl = 1.88, 3.04). After controlling for all of the above variables, the relative risks associated with prone sleeping position (OR = 4.84). sharing bed (OR = 2.02), maternal smoking (OR = 1.79) and not breast feeding (OR = 1.89) were still statistically significant. Population‐attributable risk calculations suggest that these four risk factors may account for 82% of deaths from SIDS. The SIDS mortality rate may fall to less than 0.7/1000 live births if all parents stop putting their infants down to sleep in the prone position, do not sleep with their baby, do not smoke, and breast fee

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1992.tb02729.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1992.tb02609.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractA 3 year case‐control study identifying the risk factors for SIDS was undertaken. Preliminary analysis of the data from the first year suggested that SIDS mortality could fall by 50% if the prevalence of the prone sleeping position changed from 40 to 0%. During the 3 year study the prevalence of the prone sleeping position among infants has fallen from 43% in the first year to 20% in the third year. SIDS mortality has fallen to 3.1/1000 live births, which is very close to that predicted. When considered with other available evidence this strongly supports a causal relationship between the prone sleeping position and SID

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1992.tb02732.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1992.tb02610.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractThis study was carried out in response to reports from nurses to a post‐neonatal mortality review committee that a number of mothers of infants dying from sudden infant death syndrome (SIDS) appeared to be depressed before the child's death. The New Zealand Cot Death Study was a 3 year multicentre case‐control study for SIDS. There were 485 SIDS cases in the post‐neonatal age group in the study regions, and these were compared with 1800 control infants. Infants of mothers with either a self‐reported use of medication for psychiatric disorders, a history of hospitalization for psychiatric illness or a family history of postnatal depression had a significantly increased risk of SIDS compared with infants of mothers who were either not using medication (odds ratio (OR) = 1.45; 95% confidence interval (Cl) = 1.03, 2.04) or were without a history of hospitalization for psychiatric illness (OR = 1.80; 95% Cl = 1.03, 3.11) or a family history of postnatal depression (OR = 1.61; 95% Cl = 1.06, 2.43). All mothers of infants born in the study areas over a 1 year period were eligible to complete a questionnaire measuring maternal depression when the infant was 4 weeks of age. Thirty‐three infants subsequently died from SIDS, and they were compared with 174 controls. Fifteen (45.5%) of the mothers of cases were depressed, compared with 28 (16.1%) of the mothers of controls. This prospective study found that the infants of those mothers that were depressed were more likely to die from SIDS than those of the non‐depressed mothers (OR = 4.35; 95% Cl = 1.82, 10.37) and postnatal depression as a risk factor for SIDS was still significant after controlling for possible confounding variables (OR = 3.37; 95% Cl = 1.24, 9.12). We conclude that postnatal depression is a risk fact

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1992.tb02724.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractThe New Zealand Cot Death Study is a 3 year multicentre case‐control study aimed at identifying the risk factors for sudden infant death syndrome (SIDS). The paper describes some of the legal and ethical issues which arose in the planning, implementation and analysis of the stud

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1992.tb02725.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractThe possibility that most cases of sudden infant death syndrome (SIDS) are caused by a transmissible agent is explored. A hypothesis of causation is developed using pathological and epidemiological data and our microbiological findings. The nature and distribution of vascular damage together with the consistent finding of liquid blood, in addition to the epidemiological features of SIDS, form the basis of the hypothesis that a bacterial toxin is a likely single cause of most cases of the syndrome. Future research ideas and a new definition of SIDS are proposed.

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1992.tb02727.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractAccidental injury is the major cause of death among Australian children. Many childhood injuries are preventable through the use of safety devices such as those recommended by the Child Accident Prevention Foundation of Australia (CAPFA). It has been suggested that poor availability and the high cost of obtaining and installing safety devices may contribute to their low rates of use among families with young children. This paper assesses the availability and cost of recommended safety devices in a medium sized city in Australia. Of the 17 devices recommended by the CAPFA only 10 were readily available in Newcastle. The cost of purchasing and installing all the devices recommended by CAPFA amounted to $1516, or 21.4% of the annual disposable income, after the purchase of necessities, of families with children and 75.5% of the annual disposable income, after purchase of necessities, of single parents. It is argued that the cost of safety devices may be prohibitively expensive, particularly for those most at risk of suffering from injury.

ISSN:1034-4810    

DOI:10.1111/j.1440-1754.1992.tb02612.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY