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2015 ; 135
(6
): e1442-9
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Sudden infant death syndrome and residential altitude
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Katz D
; Shore S
; Bandle B
; Niermeyer S
; Bol KA
; Khanna A
Pediatrics
2015[Jun]; 135
(6
): e1442-9
PMID26009621
show ga
BACKGROUND: Theories of sudden infant death syndrome (SIDS) suggest hypoxia is a
common pathway. Infants living at altitude have evidence of hypoxia; however, the
association between SIDS incidence and infant residential altitude has not been
well studied. METHODS: We performed a retrospective cohort study by using data
from the Colorado birth and death registries from 2007 to 2012. Infant
residential altitude was determined by geocoding maternal residential address.
Logistic regression was used to determine adjusted association between
residential altitude and SIDS. We evaluated the impact of the Back to Sleep
campaign across various altitudes in an extended cohort from 1990 to 2012 to
assess for interaction between sleep position and altitude. RESULTS: A total of
393?216 infants born between 2007 and 2012 were included in the primary cohort
(51.4% boys; mean birth weight 3194 ± 558 g). Overall, 79.6% infants resided at
altitude <6000 feet, 18.5% at 6000 to 8000 feet, and 1.9% at >8000 feet. There
were no meaningful differences in maternal characteristics across altitude
groups. Compared with residence <6000 feet, residence at high altitude (>8000
feet), was associated with an adjusted increased risk of SIDS (odds ratio 2.30;
95% confidence interval 1.01-5.24). Before the Back to Sleep campaign, the
incidence of SIDS in Colorado was 1.99/1000 live births and dropped to 0.57/1000
live births after its implementation. The Back to Sleep campaign had similar
effect across different altitudes (P = .45). CONCLUSIONS: Residence at high
altitude was significantly associated with an increased adjusted risk for SIDS.
Impact of the Back to Sleep campaign was similar across various altitudes.
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