パースのカーティン大学のコリーンオリアリーが率いる研究者たちは、1983年と2005年の間に出産した77895人の女性の情報を検討し、大量飲酒者と診断された21841人の女性から SIDSの171例は生まれ、そうでない母親56054人から生まれた子どもではSIDSは132 例だった。妊娠中に大量飲酒した母親から生まれた子どもは、飲酒問題なしの母親の子どもに比べて、SIDSのリスクは7倍に増加していた。出産後1年以内に飲酒した母親から生まれた子どものSIDSリスクは9倍だった。
Mom's drinking tied to infant deaths: study
By Andrew M. Seaman
NEW YORK | Tue Feb 26, 2013 3:36pm EST
(Reuters Health) - About one in six sudden infant deaths may be linked to their mothers' heavy alcohol use during or soon after pregnancy, according to a new study from Australia.
Researchers found those deaths may result from babies being exposed to alcohol in the womb and from alcohol-using mothers creating hazardous environments for the babies after birth.
"One of the morals of the story is that parents should be very careful about drinking alcohol, especially if you're a single parent because there is no other parent to back you up," said David Phillips, a professor at the University of California, San Diego, who has studied alcohol-related infant deaths but wasn't involved in the new research.
The U.S. Centers for Disease Control and Prevention (CDC) defines sudden infant death syndrome (SIDS) - also known as sudden unexpected infant death - as the death of a child under one year old with no obvious cause.
Approximately 4,500 infant deaths fall into this category every year in the U.S., according to the CDC.
Previously, researchers have tied SIDS to parents' smoking and to unsafe environments, but few studies have looked at whether alcohol could be involved in some of the deaths.
For the new study, the researchers, led by Colleen O'Leary from Curtin University in Perth, examined information on 77,895 women who gave birth between 1983 and 2005.
They compared the number of SIDS and infant deaths that occurred in children of mothers with a diagnosed drinking problem, to cases among the children of mothers without a diagnosis.
Overall, 171 SIDS cases occurred during that time in children born to the 21,841 women who were diagnosed heavy drinkers. Among the children who were born to 56,054 mothers without a diagnosis, there were 132 SIDS cases.
The researchers found that babies born to mothers who drank heavily during pregnancy had a seven-fold increase in the risk of SIDS, compared to children of mothers without a drinking problem.
Babies also had a nine-fold increased risk of SIDS when their mothers drank within the year after birth, compared to babies born to mothers who didn't drink.
O'Leary, who could not be reached for comment, and her colleagues also report that heavy drinking during pregnancy was tied to a doubled risk of infants dying from a cause unrelated to SIDS, compared to babies of mothers who were not heavy drinkers.
"The results of this study indicate that maternal alcohol-use disorder increases the risk of SIDS and (infant deaths) through direct effects on the fetus and indirectly through environmental risk factors," the team wrote in the journal Pediatrics on Monday.
The authors add that previous research suggests babies exposed to alcohol in the womb may have abnormalities in the brainstem, which could lead to problems regulating basic body functions like breathing.
But Phillips pointed out that the study found a link between infant deaths and a mothers' drinking as long as one year after giving birth.
"So it can't just be a biological explanation of what's going on," he said.
The mothers may be creating unsafe environments for their children, Phillips said. For example, a drunken parent may fall asleep with their baby in bed, and accidentally roll over and suffocate the child.
O'Leary's team writes that it found a number of causes for the children's deaths, including problems related to alcohol exposure in the womb and environmental factors - such as smoke inhalation, dehydration, infections and neglect.
The researchers suggest that preventing heavy drinking in mothers may bring the number of SIDS cases and infant deaths down.
A separate study, also published Monday in Pediatrics, found that doctors can use visualization and mapping software to identify babies who have slight facial deformities that may signal mental impairments from their mothers' drinking.
Phillips said it's also important for parents to understand that it only takes a couple drinks for their judgment to become impaired, and parents who plan to have a drink should have a sober "designated parent" to care for their child.
"A child is a vulnerable creature and we really owe it to protect that child. It's not a trivial thing to be a parent," he said.
SOURCE: Pediatrics, online February 25, 2013.
Published online February 25, 2013
Maternal Alcohol Use and Sudden Infant Death Syndrome and Infant Mortality Excluding SIDS
Colleen M. O’Leary, BSc, MPH, PhDa,b, Peter J. Jacoby, BA, MScb, Anne Bartu, RN, PhDc, Heather D’Antoine, BAppSc, MHEcond, and Carol Bower, MBBS, MSc, PhD, FAFPHM, DLSHTMb
aCentre for Population Health Research, Curtin Health Innovation Research Institute, and
cFaculty of Health Sciences, School of Nursing and Midwifery, Curtin University, Perth, Western Australia;
bDivision of Population Sciences, Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Perth, Western Australia; and
dMenzies School of Health Research, Darwin, Northern Territory, Australia
BACKGROUND: Improvements in the rate of infant mortality (death in first year of life) have not occurred in recent years. This study investigates the association between maternal alcohol-use disorder and sudden infant death syndrome (SIDS) and infant mortality not classified as SIDS using linked, population-based health and mortality data.
METHODS: Exposed mothers were identified through the presence of an International Classification of Diseases 9/10 alcohol diagnosis, a proxy for alcohol-use disorder, recorded on health, mental health, and/or drug and alcohol datasets (1983?2005). Comparison mothers without an alcohol diagnosis were frequency matched to exposed mothers on maternal age within maternal race and year of birth of their children. All offspring with their birth recorded on the Midwives Notification System compose the exposed (n = 21?841) and comparison (n = 56?054) cohorts. Cases of SIDS (n = 303) and infant mortality excluding SIDS (n = 598) were identified through linkage with the Western Australian Mortality Register. Analyses were conducted by using Cox regression and results presented as adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs).
RESULTS: The highest risk of SIDS occurred when a maternal alcohol diagnosis was recorded during pregnancy (aHR 6.92, 95% CI 4.02?11.90) or within 1 year postpregnancy (aHR 8.61, 95% CI 5.04?14.69). An alcohol diagnosis recorded during pregnancy more than doubled the risk of infant deaths (excluding SIDS) (aHR 2.35, 95% CI 1.45?3.83). Maternal alcohol-use disorder is attributable for at least 16.41% (95% CI 9.73%?23.69%) of SIDS and 3.40% (95% CI 2.28%?4.67%) of infant deaths not classified as SIDS.
CONCLUSIONS: Maternal alcohol-use disorder is a significant risk factor for SIDS and infant mortality excluding SIDS.
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