title: Maternal alcohol use and sudden infant death syndrome and infant mortality excluding SIDS.
abstract: BACKGROUND
  Improvements in the rate of infant mortality (death in first year of life) have not occurred in recent years. This study investigates the association between maternal alcohol-use disorder and sudden infant death syndrome (SIDS) and infant mortality not classified as SIDS using linked, population-based health and mortality data.
  
  
  METHODS
  Exposed mothers were identified through the presence of an International Classification of Diseases 9/10 alcohol diagnosis, a proxy for alcohol-use disorder, recorded on health, mental health, and/or drug and alcohol datasets (1983-2005). Comparison mothers without an alcohol diagnosis were frequency matched to exposed mothers on maternal age within maternal race and year of birth of their children. All offspring with their birth recorded on the Midwives Notification System compose the exposed (n = 21 841) and comparison (n = 56 054) cohorts. Cases of SIDS (n = 303) and infant mortality excluding SIDS (n = 598) were identified through linkage with the Western Australian Mortality Register. Analyses were conducted by using Cox regression and results presented as adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs).
  
  
  RESULTS
  The highest risk of SIDS occurred when a maternal alcohol diagnosis was recorded during pregnancy (aHR 6.92, 95% CI 4.02-11.90) or within 1 year postpregnancy (aHR 8.61, 95% CI 5.04-14.69). An alcohol diagnosis recorded during pregnancy more than doubled the risk of infant deaths (excluding SIDS) (aHR 2.35, 95% CI 1.45-3.83). Maternal alcohol-use disorder is attributable for at least 16.41% (95% CI 9.73%-23.69%) of SIDS and 3.40% (95% CI 2.28%-4.67%) of infant deaths not classified as SIDS.
  
  
  CONCLUSIONS
  Maternal alcohol-use disorder is a significant risk factor for SIDS and infant mortality excluding SIDS.
authors: Centre for Population Health Research, Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia. colleen.oleary@curtin.edu.au
authors: Colleen M
authors: CM
authors: O'Leary
authors: Peter J
authors: PJ
authors: Jacoby
authors: Anne
authors: A
authors: Bartu
authors: Heather
authors: H
authors: D'Antoine
authors: Carol
authors: C
authors: Bower
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D011159:Population Surveillance / Q000379:methods; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000175:diagnosis / Q000401:mortality*; D013398:Sudden Infant Death / Q000175:diagnosis / Q000453:epidemiology*; D055815:Young Adult