Major Risk Factors Identified for Sudden Infant Death Syndrome

Results of European research in this week's issue of THE LANCET highlight how basic child-care strategies-such as preventing babies from sleeping face-down, using appropriate bedding, and discouraging bed-sharing with mothers who smoke-could reduce the risk of 'cot death' (sudden unexplained infant death syndrome [SIDS]).

Four large studies were set up to re-examine the epidemiology of SIDS after striking changes in rates of this phenomenon around 1990. The European Concerted Action on SIDS (ECAS) investigation brings together data from these and new studies to give an overview of risk factors for the syndrome in Europe.

745 SIDS cases and around 2400 controls were obtained from 20 European centres. Major factors increasing risk of SIDS were: prone (face-down) sleeping position of infant; turning the infant from side to prone position; infant head-covering with bedding; household smoking; bed-sharing with a mother who smoked; bed-sharing with non-smoking mother for infants up to eight weeks of age; and mothers' alcohol consumption over previous 24 hours (if bed-sharing with an infant).

Lead investigator Robert Carpenter from the London School of Hygiene and Tropical Medicine, UK, comments: "Avoidable risk factors such as those associated with inappropriate infants' sleeping position, type of bedding used, and sleeping arrangements strongly suggest a basis for further substantial reductions in SIDS incidence rates."

Contact: Dr Robert G Carpenter, Medical Statistics Unit, Department of Epidemiology & Public Health, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK; T)+44 (0)1689 859244; E) bob.carpenter@lshtm.ac.uk or LSHTM press Office on +44 (0)20 7927 2073; E) lindsay.wright@lshtm.ac.uk

Lancet 2004; 363: 185-191