Changes in the epidemiology of sudden infant death syndrome in Sweden 1973-1996

Background-From the early 1970s to the early 1990s, there was a significant rise in the incidence of sudden infant death syndrome (SIDS) in Scandinavi a. Following the risk reducing campaign, the incidence has fallen to about the same level as in 1973. Aims-To identify the changes that have occurred in the epidemiology of SIDS . Methods-We compared the Swedish part of the Nordic Epidemiological SIDS Stu dy (NESS), covering the years 1992-1995, with two earlier, descriptive stud ies during this period. To assess the changing effects of risk factors, we analysed data from the Medical Birth Registry of Sweden, covering the years 1973-1996. Results-There was a predominance of deaths during weekends in the 1970s and 1990s. The seasonal variation was most notable in the 1980s. The proportio n of young mothers decreased from 14% to 5%. Cohabitation (living with the biological father) was as frequent in the 1990s as in the 1970s. The preval ence of high parity, admissions to neonatal wards, low birth weight, premat urity, and multiple pregnancies were all increased in the 1990s compared to the 1970s. No significant change in the prevalence of previous apparent li fe threatening events was found. Deaths occurring in cars diminished from 1 0% to below 2%. In the data from the Medical Birth Registry of Sweden, ther e were significantly increased odds ratios after the risk reducing campaign of the risk factors smoking during early pregnancy and preterm birth. We c ould find no increased effects of maternal age, parity, or being small for gestational age over time. The rate of deaths at weekends remained increase d; the median age at death fell from 90 to 60 days. Seasonal variation was less notable in the periods of low incidence.