Racial Differences in Risk Factors for Sudden Infant Death Syndrome: A Case-Control Study in North Carolina

In both North Carolina and the United States, Sudden Infant Death Syndrome (SIDS) occurs at an elevated rate among black infants compared to white infants. Relatively little is known about the causes of this racial disparity. Accordingly, the present study explores the extent to which a range of previously-identified risk factors may underlie racial differences in SIDS rates. To investigate these issues, a case-control study was conducted using vital statistics data for the 1990-1994 North Carolina birth cohorts. Chi-square and logistic regression analyses were used to examine differences in the prevalence and predictiveness of various maternal, prenatal, and perinatal risk factors among SIDS cases and controls for each racial group. Results demonstrated that the heightened risk of SIDS for black infants disappears after adjustment for all measured risk factors. This suggests that the elevated SIDS rate among blacks relative to whites is due primarily to higher incidence of the risk factors in this minority group. Maternal smoking during pregnancy, low birth weight, inadequate prenatal care, and low maternal education were associated significantly with SIDS for both races, suggesting that each of these risk factors independently contributes to the risk of SIDS among blacks as well as whites. The results are discussed in terms of populations subgroups towards which interventions for SIDS should be targeted. SCHS Studies NORTH CAROLINA DEPARTMENT OF ENVIRONMENT, HEALTH AND NATURAL RESOURCES A Special Report Series by the State Center for Health Statistics P.O. Box 29538, Raleigh, N.C. 27626-0538 www.schs.state.nc.us/SCHS/ North Carolina Public Health ®