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World Journal of Pediatrics

29-04-2024 | Sudden Infant Death Syndrome | Meta-analysis

Prenatal and postnatal factors associated with sudden infant death syndrome: an umbrella review of meta-analyses

Authors: Tae Hyeon Kim, Hyeri Lee, Selin Woo, Hayeon Lee, Jaeyu Park, Guillaume Fond, Laurent Boyer, Jong Woo Hahn, Jiseung Kang, Dong Keon Yon

Published in: World Journal of Pediatrics

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Abstract

Background

Comprehensive quantitative evidence on the risk and protective factors for sudden infant death syndrome (SIDS) effects is lacking. We investigated the risk and protective factors related to SIDS.

Methods

We conducted an umbrella review of meta-analyses of observational and interventional studies assessing SIDS-related factors. PubMed/MEDLINE, Embase, EBSCO, and Google Scholar were searched from inception until January 18, 2023. Data extraction, quality assessment, and certainty of evidence were assessed by using A Measurement Tool Assessment Systematic Reviews 2 following PRISMA guidelines. According to observational evidence, credibility was graded and classified by class and quality of evidence (CE; convincing, highly suggestive, suggestive, weak, or not significant). Our study protocol was registered with PROSPERO (CRD42023458696). The risk and protective factors related to SIDS are presented as equivalent odds ratios (eORs).

Results

We identified eight original meta-analyses, including 152 original articles, covering 12 unique risk and protective factors for SIDS across 21 countries/regions and five continents. Several risk factors, including prenatal drug exposure [eOR = 7.84 (95% CI = 4.81–12.79), CE = highly suggestive], prenatal opioid exposure [9.55 (95% CI = 4.87–18.72), CE = suggestive], prenatal methadone exposure [9.52 (95% CI = 3.34–27.10), CE = weak], prenatal cocaine exposure [4.38 (95% CI = 1.95–9.86), CE = weak], prenatal maternal smoking [2.25 (95% CI = 1.95–2.60), CE = highly suggestive], postnatal maternal smoking [1.97 (95% CI = 1.75–2.22), CE = weak], bed sharing [2.89 (95% CI = 1.81–4.60), CE = weak], and infants found with heads covered by bedclothes after last sleep [11.01 (95% CI = 5.40–22.45), CE = suggestive], were identified. On the other hand, three protective factors, namely, breastfeeding [0.57 (95% CI = 0.39–0.83), CE = non-significant], supine sleeping position [0.48 (95% CI = 0.37–0.63), CE = suggestive], and pacifier use [0.44 (95% CI = 0.30–0.65), CE = weak], were also identified.

Conclusions

Based on the evidence, we propose several risk and protective factors for SIDS. This study suggests the need for further studies on SIDS-related factors supported by weak credibility, no association, or a lack of adequate research.

Graphical abstract

Appendix
Available only for authorised users
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Metadata
Title
Prenatal and postnatal factors associated with sudden infant death syndrome: an umbrella review of meta-analyses
Authors
Tae Hyeon Kim
Hyeri Lee
Selin Woo
Hayeon Lee
Jaeyu Park
Guillaume Fond
Laurent Boyer
Jong Woo Hahn
Jiseung Kang
Dong Keon Yon
Publication date
29-04-2024
Publisher
Springer Nature Singapore
Published in
World Journal of Pediatrics
Print ISSN: 1708-8569
Electronic ISSN: 1867-0687
DOI
https://doi.org/10.1007/s12519-024-00806-1