Racial differences in the impact of maternal smoking on sudden unexpected infant death

J Perinatol. 2023 Mar;43(3):345-349. doi: 10.1038/s41372-022-01516-0. Epub 2022 Oct 21.

Abstract

Background: Prenatal smoking increases the risk of Sudden Unexpected Infant Death (SUID). Whether exposure patterns and associations differ by race requires further study.

Objectives: Determine if patterns of exposure and associations between SUID and maternal smoking before and during pregnancy differ by race.

Methods: Using U.S. National Center for Health Statistics linked birth/infant death files 2012-2013, we documented SUID by smoking duration and race. Maternal smoking history: never, pre-pregnancy only, and pre-pregnancy plus first, first, second, or all trimesters.

Results: Smoking was more common in non-Hispanic White (NHW) than non-Hispanic Black (NHB) mothers and more evident for both in SUID cases. The most common exposure duration is from before and throughout pregnancy (SUID: 78.3% NHW, 66.9% NHB; Survivors: 60.22% and 53.96%, respectively). NHB vs. NHW SUID rates per 1000 live births were 1.07 vs. 0.34 for non-smokers and 3.06 and 1.79 for smokers, ORs trended upward for both with increasing smoking duration.

Conclusion: Fewer NHB mothers smoked, but both NHB and NHW groups exhibited a dose-response relationship between smoking duration and SUID. The most common duration was from before to the end of pregnancy, suggesting difficulty in quitting and a need for effective interventions.

Publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • Female
  • Humans
  • Infant
  • Infant Mortality
  • Pregnancy
  • Race Factors
  • Smoking* / adverse effects
  • Sudden Infant Death* / epidemiology
  • Sudden Infant Death* / etiology
  • Tobacco Smoking