CASE-CONTROL STUDY OF CURRENT VALIDITY OF PREVIOUSLY DESCRIBED RISK-FACTORS FOR SIDS IN THE NETHERLANDS

This study aimed to assess whether previously established risk factors for sudden infant death syndrome (SIDS) are still valid now that the incidence in the Netherlands has dropped to 0.26 per 1000 liveborn inf ants. A distinction was made between immutable and mutable risk factor s. This case-control study (part of the European Concerted Action on S IDS) comprised 73 SIDS cases and 146 controls and lasted from March 19 95 to September 1996. Adjustments were made for sleeping position and bedding factors by treating them as covariables. Apart fr-om these fac tors, well known risk factors that remain of importance in the Netherl ands are: male sex, young maternal age, twins, and low socioeconomic s tatus. These factors are largely immutable. Other well known risk fact ors which might reflect attitudes to child care and could possibly be mutable ape: smoking, alcohol consumption by the mother, bottle feedin g, and change of babycare routine. Intervention strategies should focu s on early signalling, thereby assisting parents in changing these unf avourable parenting attitudes. Information on optimal child care and e xtra support by public health nurses specifically aimed at families at risk could help to decrease further the incidence of SIDS in the Neth erlands.