Concordance of parental race/ethnicity in relation to the risk of sudden infant death syndrome (SIDS).
It has been reported that parental human leukocyte antigen (HLA) compatibility is associated with certain adverse reproductive outcomes such as multiple spontaneous fetal losses and malformations, particularly among women without a prior livebirth. In order to study the relation between parental HLA compatibility and the risk of SIDS, a population-based case-control study was conducted using 1982-1990 Washington State linked birth and death certificate data. Concordance of parental race/ethnicity combined with prior maternal fetal loss was used as surrogate measures of parental HLA compatibility. The relation was evaluated separately among infants with and without a prior live-born sibling. Among first liveborn infants, those of racially discordant parents were at reduced risk of SIDS compared with those of racially concordant parents (relative risk [RR] = 0.57, 95% confidence interval = 0.34-0.96). Infants of white-minority parents were all at lower risk of SIDS than infants of white-white parents. Infants of racially concordant parents with two or more prior fetal losses were at increased risk of SIDS (RR = 2.44, 1.07-5.56), relative to infants of racially discordant parents. No such associations were observed among infants with prior live-born siblings. In fact, in this latter population, infants of racially concordant parents tended to have a lower risk of SIDS than those of discordant parents. This study suggests that a portion of SIDS cases, particularly among first live-born infants, may be due to parental HLA sharing. However, final determination of the existence of this relationship requires actual HLA typing of parents of both cases and controls.
Li
D K
DK
Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle.
Daling
J R
JR
D000328:Adult; D016022:Case-Control Studies; D005260:Female; D005313:Fetal Death; D006680:HLA Antigens / Q000235:genetics; D006801:Humans; D007231:Infant, Newborn; D010290:Parents; D044469:Racial Groups; D012307:Risk Factors; D013398:Sudden Infant Death / Q000208:ethnology* / Q000209:etiology; D014861:Washington / Q000453:epidemiology
D006680:HLA Antigens