Children born to mothers who drank and smoked have 12-FOLD increased risk of suddenly dying

Cot death is 12 times more likely in children born to mothers who drank and smoked while pregnant, researchers have found. 

Scientists followed the outcomes of 12,000 pregnancies among women from South Africa and the US for eight years.

Children born to mothers who drank and smoked beyond their first three months of pregnancy had a much higher risk of dying suddenly. 

Results showed there was a five-fold risk for children whose mothers gave up alcohol but carried on smoking beyond the first trimester.

And there was a four-fold risk for children born to mothers in the opposite situation, giving up cigarettes but carrying on with drinking. 

Sudden infant death syndrome (SIDS), or cot death, is the sudden and unexplained death of a child under the age of one. 

Children born to mothers who drank and smoked while pregnant have a 12-fold increased risk of dying suddenly, scientists have found 

Around 230 babies in the UK and 2,500 in the US die from SIDS each year, figures show. 

The cause of SIDS is unknown – but a wealth of evidence exists to show that both smoking and drinking increase the risk.   

The latest study is the first to look at how the risk is influenced by the timing and amount of exposure to both tobacco and alcohol in the womb. 

Researchers based at Avera Health Center for Pediatric & Community Research in South Dakota worked with a team in South Africa. 

Women living in areas of Cape Town and five areas in the US, including those living in two American Indian reservations, were tracked. 

The areas were selected for their high rates of both alcohol use in pregnancy and SIDS. 

They found that 66 babies died in their first year of life, with 28 dying from SIDS and 38 others from known causes. 

The risks of dying were compared to those for babies who had not been exposed to alcohol or tobacco.

They were also compared to babies whose mothers quit smoking or drinking after three months of being pregnant. 

The study was reported in EclinicalMedicine, an online journal published by the Lancet. 

Lead author Dr. Amy Elliot said that exposure to both alcohol and tobacco produce a ‘substantially higher’ risk of sudden death than exposure to either.     

A statement from the US’s National Institutes of Health, which supported the study, said: ‘These findings provide still more evidence of the vital importance of the early prenatal environment to healthy postnatal outcomes.

‘Insofar as many women quit drinking and smoking only after they learn that they are pregnant, this study argues strongly for screening for substance use early in pregnancy and intervening as soon as possible.’

‘It also calls for stronger public health messaging regarding the dangers of drinking and smoking during pregnancy, and among women who plan to become pregnant.’ 

Dr Elliot added: ‘The Safe Passage Study results show that the quantity, frequency and timing of exposures played a critical role in risk of SIDS. 

‘These findings support the Center for Disease Control and Prevention, the United States Surgeon General, and the World Health Organization’s recommendation of no smoking or drinking during pregnancy and emphasize the importance of dual exposure, which provides the greatest risk for infant mortality.

‘Given that many women quit drinking and smoking after pregnancy recognition, this finding has great public health impact for screening for substance use early and intervening as soon as possible.’

Previous studies have suggested smoking may impact rates of sudden death by harming unborn babies’ breathing.   

Nicotine in tobacco damages brain cells that control the tongue – stopping it from moving and opening the airway.

In the womb babies have short pauses in breathing that last a few seconds before the tongue kicks into action and revives them. 

Known as hypoglossal neurons, they control a nerve that runs from grey matter to the underside of the tongue.

But a discovery made by Arizona University scientists suggests a potential mechanism whereby infants stop breathing during sleep – leading to SIDS.

It is also thought that parents who consume alcohol before sharing beds with their newborns may increase risk of them dying suddenly. 

WHAT IS COT DEATH AND HOW CAN IT BE PREVENTED?

Sudden infant death syndrome (SIDS), or cot death, is the sudden, unexpected and unexplained death of an apparently healthy baby.

SIDS kills around 2,500 babies in the US and just under 300 in the UK every year.

It usually occurs within the first six months of an infant’s life and is more common in those born prematurely or of a low birth weight.

The cause of SIDS is unknown, however, it is associated with tobacco smoke, tangled bedding, co-sleeping with parents and breathing obstructions.

Prevent the risk by:

  • Placing sleeping babies on their backs
  • Keeping babies’ heads uncovered
  • Sleeping in the same room as babies for the first six months of their lives
  • Using a firm, flat, waterproof mattress in babies’ cribs
  • Breastfeeding, if possible 

Do not:

  • Smoke during pregnancy or in the same room as a baby
  • Sleep on a bed or chair with an infant
  • Allow babies to get too hot or cold. Temperatures between 16 and 20C should be comfortable 

Source: NHS Choices 

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