Association of Maternal Smoking and other Risk Factors with Sudden Infant Death Syndrome (SIDS)

Abstract

Background: Sudden infant death syndrome (SIDS) has been one of the leading causes of infant death globally. Its exact cause is still unknown. However, certain factors have been attributed to increase its risk. Objective: This systematic review aims to study the association of various infant and maternal characteristics with the incidence of sudden infant death syndrome (SIDS). It aims to provide a better understanding of this topic to parents and caregivers, healthcare professionals, public health workers, government, International organisations and related policy makers. Methodology: Keeping in account the PRISMA protocol, a literature search was done using various databases including PubMed, Google Scholar, Science Direct, Cochrane and PakMediNet. The articles included were in English and within a 10-year timeline from January 2013 till December 2023. Reviewers assessed the studies for eligibility and screening was done multiple times based on predefined inclusion and exclusion criterion. Analysis was done for risk factors that include maternal age, maternal smoking, perinatal substance abuse, infant gender, plurality, parity, parent’s education, sleeping position, bed-sharing, gestation period, breast feeding and birth weight. Data extraction was performed and reviewed by the authors Results: A total of 18 studies were included in the final review that discussed a total of 92,412 sudden infant deaths syndrome cases. The risk factors were then categorised into maternal and infant factors. The included studies were diverse in study designs and countries of origin. 10 studies (55%) discussed maternal age of 20-35 years as a risk factor whereas 35+ age was constantly registered as a protective factor. 7 studies (39%) discussed infant gender (high risk in males) and gestational age (high risk in <37 weeks gestation). Low birthweight (<2500gm) and low parental education (less than high school) was also reported as a risk factor. 75% of studies discussed sleeping position and reported prone position as a problem. Conclusions: Smoking during pregnancy, young maternal age, low education and alcohol abuse increase the risk of sudden infant death syndrome. Similarly, prone sleeping position, low gestational age, low birth weight, co-sleeping, male infants and multifetal pregnancy are associated with higher risk of sudden infant death syndrome.