The Association Between Birth Delivery Method and Sudden Infant Death Syndrome Open Access

Abstract

THE ASSOCIATION BETWEEN BIRTH DELIVERY AND SUDDEN INFANT
DEATH SYNDROME
Objectives: Sudden Infant Death Syndrome (SIDS) is sudden death of an infant less than
one year of age that cannot be explained after a thorough investigation is conducted,
including a complete autopsy, examination of the death scene, and review of the clinical
history. Risk factors for SIDS have been identified, including maternal behavioral and
health factors and certain infant health factors; however, mode of delivery has not been
sufficiently studied to rule it out as a risk factor. Studies have found conflicting
information on the safety of cesarean sections, which are occurring at increasing rates
within the United States. This study examines whether infants born via cesarean are at
increased risk for SIDS.
Methods: Period linked birth-infant death files for 2005 and 2006 were used to obtain a
final study population of 1,254 cases and 3,148,977 controls. Delivery method was
categorized as vaginal or cesarean section. Odds ratios and risk ratios were examined
using three separate models: 1) only pregnancy characteristics 2) pregnancy and maternal
characteristics 3) pregnancy, maternal, and infant characteristics.
Results: Cesarean births accounted for 29.82% of all SIDS cases. Infants born via
cesarean were not at increased chance of SIDS with the largest odd ratio of 1.10 which
occurred when only pregnancy and maternal characteristics were adjusted for. Separating
births into vaginal, vaginal delivery after previous cesarean (VBAC), primary cesarean,
and repeat cesarean did not influence results.
Discussion: The results of this study suggest that birth delivery method does not
influence SIDS independent of maternal and infant conditions that might necessitate a
cesarean delivery. However, since the data do not include whether a cesarean was
elective or done as an emergency procedure, further research into elective cesareans is
warranted.

Table of Contents

TABLE OF CONTENTS

Background...............................................................................Page 1
Methods...................................................................................Page 9
Study Population.......................................................................Page 9
Variables..................................................................................Page 10
Analysis...................................................................................Page 12
Results....................................................................................Page 13
Variable Categories....................................................................Page 13
Interaction, Confounding, and Collinearity Assessment......................Page 14
Variable Significance...................................................................Page 14
Discussion.................................................................................Page 16
Strengths.................................................................................Page 18
Limitations................................................................................Page 19
Future Directions........................................................................Page 20
References................................................................................Page 21
Tables and Figures......................................................................Page 25
Tables......................................................................................Page 25
Figures.....................................................................................Page 39
Appendices................................................................................Page 41

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Keyword	Sudden Infant Death SIDS
Committee Chair / Thesis Advisor	Hogue, Carol J, Emory University
Partnering Agencies	Does not apply (no collaborating organization)

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