SUDDEN-INFANT-DEATH-SYNDROME IN NEW-ZEALAND - ARE RISK SCORES USEFUL

Study objective - To evaluate the Christchurch, Invercargill, Dunedin (CID) and Oxford record linkage study (ORLS) risk scores in five regio ns of New Zealand and examine the effect of risk factors for sudden in fant death syndrome (SIDS), such as prone sleeping position, maternal smoking, breast feeding, measures of illness, the use of antenatal cla sses, community health care, and medical services on a high and low ri sk group delineated by the CID score. Design - This was a case-control study of infants dying of SIDS. Setting - Both the cases and controls were born in one of five health districts in New Zealand and their pa rents were interviewed between 1 November 1987 and 31 October 1990. Pa rticipants - The cases were 485 infants who died of SIDS. The controls were a random sample drawn from the same five regions in which the ca ses were born, chosen so that their age on the day on which they were interviewed was similar to the age at death of the cases. Risk scores were calculated for 387 case and 1579 controls. Measurements and main results - Using the recommended cut off points the sensitivity and spe cificity of the CID and ORLS were found to be similar to those describ ed for other samples. The differences among the regions were significa nt. There was, however, no evidence that the association between SIDS and the risk factors considered was different in the high and low risk groups delineated by the CID score. The relative attributable risk fo r smoking was 32.3% in the high risk group. The excess risk that could be attributed to a different prevalence of any of the other Ask facto rs in the high risk group was small when compared with the low risk gr oup. Conclusions - Health care resources should be spent on promoting and evaluating good child care practices for all, rather than identify ing and promoting special interventions for those in the high risk cat egory.