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Arch Dis Child 1998;79:506-509 ( December )

Living at high altitude and risk of sudden infant death syndrome

Ursula Kohlendorfer,a Stefan Kiechl,b Wolfgang Sperlc

a Department of Paediatrics, University of Innsbruck, Anichstrabeta e 35, A-6020 Innsbruck, Austria, b Department of Neurology, University of Innsbruck, c Children's Hospital, LKA Salzburg, Müllner Hauptstrabeta e 48, A-5020 Salzburg, Austria

Correspondence to: Dr Sperl.


Accepted 21 July 1998

OBJECTIVE---To investigate the association between altitude of residence and risk of sudden infant death syndrome (SIDS).
METHODS---A retrospective, case control study in the Tyrol, Austria enrolled 99 infants with SIDS occurring between 1984 and 1994, and 136 randomly selected control cases. Data on pregnancy, delivery, child care practice, and sociodemographic characteristics including altitude of residence were collected with a standardised questionnaire.
RESULTS---The risk of SIDS increased gradually with increasing altitude of residence. This relation remained independently significant when the analysis was adjusted for gestational age, birth weight, prenatal care, mother's age at delivery, educational level of parents, and cigarette smoking during pregnancy. The prone sleeping position emerged as an obligatory cofactor in this association. In the whole of Austria, a similar trend of association emerged between the average altitudes in the 99 political counties and the rates of SIDS.
CONCLUSIONS---This study identified altitude of residence as a significant risk predictor of SIDS, primarily in combination with the prone sleeping position. Respiratory disturbances, reduced oxygen saturation, and lower temperatures at high altitude might explain this association.

Keywords: sudden infant death syndrome; altitude; prone sleeping position

© 1998 by Archives of Disease in Childhood


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