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Sudden Infant Death Syndrome and Maternal Depression

Louise M. Howard, Ph.D.; Graham Kirkwood, M.Sc.; and Radoslav Latinovic, B.Sc.

Objective: To investigate whether there is an association between sudden infant death syndrome (SIDS) and perinatal depression.

Method: A case-control study design was used. Cases included women registered in a British primary care database with a live birth (1987-2000) and a subsequent SIDS death. Controls were women with a live birth born in the same year as the matched SIDS death, with infant survival for the first year of life.

Results: One hundred sixty-nine linked mother-infant cases of SIDS were matched with 662 mother-infant controls. The authors found that SIDS was independently associated with maternal depression in the year before birth (odds ratio [OR] = 4.93, 95% CI = 1.10 to 22.05), smoking (OR = 2.50, 95% CI = 1.29 to 4.88), and male sex (OR = 1.94, 95% CI = 1.04 to 3.64). There was weak evidence of an independent association of SIDS with depression in the 6 months after birth, before the index SIDS death (OR = 1.80, 95% CI = 0.71 to 4.56).

Conclusion: This study provides further evidence for an association between SIDS and perinatal depression, particularly antenatal depression. Health care professionals should ensure that women with perinatal depression are appropriately treated and are provided with clear advice on infant care practices that may prevent SIDS.

(J Clin Psychiatry 2007;68:1279-1283)

Received Feb. 21, 2007; accepted April 25, 2007. From the Health Services and Population Research Department, Institute of Psychiatry (Dr. Howard and Mr. Kirkwood); National Institute for Health Research Biomedical Research Center and South London and Maudsley National Health Service Foundation Trust, Institute of Psychiatry (Dr. Howard); and Division of Health and Social Care Research (Mr. Latinovic), King's College London, London, United Kingdom.

Funding for this project was provided by Guy's and St. Thomas's Charitable Foundation, London, United Kingdom.

This study was presented in part at the annual conference of the Royal College of Psychiatrists; June 21, 2007; Edinburgh, Scotland, United Kingdom.

The authors report no additional financial or other relationships relevant to the subject of this article.

Corresponding author and reprints: Louise M. Howard, Ph.D., P.O. Box 29, De Crespigny Park, London, UK SE5 8AF (e-mail: