Document Detail

Adult hemoglobin levels at birth and risk of sudden infant death syndrome.
MedLine Citation:
PMID:  15066877     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: During the final weeks of gestation, infants normally begin a transition from the production of fetal to adult hemoglobin. Delayed or faulty transition to the production of adult hemoglobin might play a role in the etiology of sudden infant death syndrome (SIDS). OBJECTIVE: To examine the association between adult hemoglobin levels measured at birth and the subsequent risk of SIDS. DESIGN AND SETTING: Cohort study of all infants born in California between March 1, 1990, and December 31, 1997, who were enrolled in the state's Newborn Screening Program and followed up during the first year of life to identify deaths attributed to SIDS. PARTICIPANTS: Population-based sample of 3.2 million infants. MAIN OUTCOME MEASURE: Risk of death attributed to SIDS. RESULTS: The study included 2425 infants whose deaths were attributed to SIDS. There was an inverse relationship between adult hemoglobin level, expressed as a percentage of total hemoglobin, and the subsequent incidence of SIDS. After adjustment for infant sex, race/ethnicity, length of gestation, maternal age, maternal education, maternal smoking, intrauterine growth restriction, and preeclampsia/eclampsia, the relative risks of SIDS for infants in the lower 4 quintiles of adult hemoglobin level were, in descending order, 1.12 (95% confidence interval [CI], 0.96-1.32), 1.38 (95% CI, 1.19-1.59), 1.55 (95% CI, 1.34-1.80), and 2.15 (95% CI, 1.87-2.47) compared with infants in the highest quintile. CONCLUSIONS: These findings suggest that infants with low levels of adult hemoglobin in the first hours after birth are at elevated risk of SIDS. Delayed maturation in production of adult hemoglobin may play a role in the etiology of some SIDS cases.
David B Richardson; Steve Wing; Fred Lorey; Irva Hertz-Picciotto
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Archives of pediatrics & adolescent medicine     Volume:  158     ISSN:  1072-4710     ISO Abbreviation:  Arch Pediatr Adolesc Med     Publication Date:  2004 Apr 
Date Detail:
Created Date:  2004-04-06     Completed Date:  2004-05-04     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9422751     Medline TA:  Arch Pediatr Adolesc Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  366-71     Citation Subset:  AIM; IM    
Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-8050, USA.
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MeSH Terms
California / epidemiology
Cohort Studies
Fetal Hemoglobin / analysis*
Follow-Up Studies
Infant, Newborn
Linear Models
Risk Factors
Sudden Infant Death / blood*,  epidemiology
Reg. No./Substance:
9034-63-3/Fetal Hemoglobin

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