Temperature and the sudden infant death syndrome

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Abstract
The relationship between the days on which sudden infant death syndrome (SIDS) occurred and daily minimum and average temperature was examined for five regions of New Zealand for a three-year period beginning on 1st November 1987. There was a marked winter excess of SIDS. After adjusting for season the temperature on the days preceding SIDS deaths were negatively associated with SIDS, but the effect was not statistically significant. Further analysis, using data from the New Zealand Cot Death Study, a nation-wide case-control study was based on the mean temperature 2 to 5 days before death for the cases or a nominated day for the controls. Statistically significant interaction effects between temperature and sleep position, and temperature and the age of the infant were found. A mean temperature 2-5 days beforehand 2.5 degrees C below that on the day of death or the nominated day increased the risk of SIDS in those sleeping prone by 1.17 [95% CI 0.95 to 1.43] and in those sleeping on their side or back by 0.96 [95% CI 0.77 to 1.19]. In the same circumstances the odds ratio (OR) for infants aged 3 months or less would increase by 0.98 [95% CI 0.80 to 1.19] and that for infants older than 3 months by 1.20 [95 CI 0.97 to 1.49]. The statistically significant negative association between temperature a few days before death and SIDS has been reported previously. Most of the effect of temperature can be attributed to seasonal variations, and minor fluctuations in day to day temperatures make only a very small contribution to SIDS.