CHILD ABUSE AS RISK FACTOR OF SUDDEN INFANT DEATH SYNDROME
Aryayev N., Kukushkin V.
Odessa State Medical University,
Odessa, Ukraine
Objective:
risk evaluation of sudden infant death syndrome (SIDS) development in
family child abuse.
Methods:
a 3-year epidemiological retrospective study of 54 SIDS cases and 108 controls matched by age and
residence area. Chi-square test was used to compare case and control
groups. To evaluate the relative risk the univariate and multivariate
logistic regression analysis were used, its interpretation was expressed in
odds ratio¡¯s (OR) with confidence interval (CI) of 95 %.
Results:
basing upon the information received from the medical staff elements of
child abuse were identified in the form of the neglected child in 10
families (18.8 %) of the case group and in 1 family of the control group
(0.9 %), the differences between the groups were verified (¦Ö2=17.33,
p=0.00001). The neglect condition included absence of due hygienic care,
inappropriate feeding regimen, ignoring of medical care workers advice. In
the univariate analysis the OR of child abuse was 24.98 (CI 1.54-402.76).
The model of multivariate regression included other social characteristics
which increased considerably the SIDS risk: low income of the family
(OR=8.19, CI 3.87-17.33), absence of higher education in mothers (OR=7.87,
CI 1.61-6.27), crowded houses (OR=2.79, CI 1.40-5.53), one-parent family
(OR=2.11, CI 0.97-4.58), jobless parents (OR=1.92, CI 0.82-4.52). After
stepwise incorporation of variables the OR of child abuse remained the
highest in the evaluated factors (OR=14.67, CI 1.12-191.30).
Conclusion:
infants who underwent child abuse (the neglected children in particular)
are the SIDS risk group. Child abuse is the most significant among other
adverse social factors connected with SIDS.