Age at Death Due to Sudden Infant Death Syndrome for Term and Pre-Term Infants Open Access

Abstract

Introduction: Premature infants are at increased risk for Sudden Infant Death Syndrome (SIDS),
the third leading cause of US infant mortality.The relationship between gestational age at birth
and age at death among SIDS cases may have important implications for understanding
physiological changes occurring during the critical developmental period after birth. We
compared age at death distributions between SIDS infants born preterm and term, and also
stratified by race and Hispanic origin and sex.

Methods: Data were obtained from the US Birth Cohort Linked Birth/Infant Death Data Sets for
2003-2005. Analysis was restricted to singleton infants born to US resident mothers between 28
and 41 weeks gestation, who died of SIDS in the postneonatal period (n=5,017). SIDS cases
were identified from the death certificate underlying International Classification of Diseases-10th
revision (ICD-10) cause-of-death code, R95. Infants were categorized into four gestational age
categories: very preterm (28-33 weeks), late preterm (34-36 weeks), early term (37-38 weeks),
and term gestations (39-41 weeks). We compared age at death distributions and used Analysis of
Variance (ANOVA) to evaluate differences in mean chronological age at death between
gestational age categories.

Results: Chronological age at death distributions for each gestational age group peaked at
approximately 9 weeks . Mean chronological age at death of SIDS was 15.2 weeks among very
preterm infants, 14.6 weeks among late preterm infants, 13.9 weeks among early term infants and
14.3 weeks among term infants. Mean chronological ages at death by gestational age group
stratified by race and Hispanic origin or infant sex were similar.

Discussion: We report no clinically meaningful difference between gestational age at birth and
chronological age at death for SIDS infants. Race-specific and sex-specific findings are similar.
Use of clinically meaningful gestational age cut points provides an insight into the relationship
between gestational age at birth and chronological age at death for SIDS. Contrary to prior
reports, the critical window of vulnerability does not appear to be modified by gestational age at
birth. Caregivers should be aware of the increased SIDS risk among preterm infants, but should
practice SIDS risk reduction for all infants regardless of gestational age at birth.

Table of Contents

Table of Contents

CHAPTER I: LITERATURE REVIEW ......................................................................................................1
CHAPTER II ...................................................................................................................................13
ABSTRACT .....................................................................................................................................13
INTRODUCTION ...............................................................................................................................13
METHODS ......................................................................................................................................15
RESULTS ........................................................................................................................................16
DISCUSSION ...................................................................................................................................17
REFERENCES ...................................................................................................................................23
TABLES ..........................................................................................................................................29
FIGURES .........................................................................................................................................27
APPENDIX ......................................................................................................................................30

About this Master's Thesis

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• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Epidemiology
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Keyword	Age at Death Prematurity Sudden Infant Death Syndrome
Committee Chair / Thesis Advisor	Howards, Penelope, Emory University
Committee Members	Shaprio-Mendoza, Carrie, CDC, Division of Reproductive Health
Partnering Agencies	CDC

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