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Avera Researcher Publishes World’s Largest Prospective Study on SIDS Risk

Feb 25, 2020 07:00AM ● By MED Magazine

Doctors have known for decades that prenatal alcohol exposure can lead to cognitive impairment and developmental disabilities. Likewise, smoking increases the risk for prematurity, infection, and low birthweight. 

Now, research published by Amy Elliott, PhD, Chief Clinical Research Officer of the Avera Center for Pediatric and Community Research in Sioux Falls, has taken this knowledge a step further. In the largest prospective study ever conducted on SIDS, Elliott and her colleagues found that drinking and smoking together increase risk more than either by itself. 

Amy Elliott, PhD, Chief Clinical Research Officer of the Avera Center for Pediatric and Community Research in Sioux Falls

“The combination increases the risk for SIDS synergistically and that risk skyrockets by almost 12 times when the behavior continues past the first trimester of pregnancy,” says Elliott. 

The data is compelling. Elliott was part of a large international team that enrolled more than 10,000 women in early pregnancy for a study that spanned 15 years. The five US enrollment sites included two American Indian reservations. Approximately 5,500 of the mothers came from the South Dakota region. 

“It is the largest prospective study ever done on SIDS and probably the largest that will ever be done,” says Elliott of the NIH-funded “Safe Passage” study. “The strength of the evidence is very, very strong.” 

It’s size was not the only thing that made Safe Passage unique. 

Jyoti Angal, MPH, Director of Clinical Research at the Avera Center for Pediatric and Community Research

“Prospective studies are often a challenge to run because of the need for compliance,” says Jyoti Angal, MPH, Director of Clinical Research at the Avera Center for Pediatric and Community Research. “These women had to commit to multiple appointments during pregnancy and up to 18 months afterward. The fact that we had over 86 percent compliance for those visits speaks to the relationships formed between staff and patients.”

Dr. Elliott says the most important message clinicians should take from her research is not to assume knowledge on the part of their pregnant patients. 

“It's critical to get rid of assumptions about what women know and don’t know and and make sure that all women are receiving this information in a way that supports them in making changes for a healthy pregnancy,” says Elliott.

Although Safe Passage has concluded, it will continue to contribute to medical knowledge for years to come. A second study, called ECHO, will provide ongoing followup with 2,500 of the children born to study participants. It could shed light on the link between habits during pregnancy and rates of various health conditions over time. 

“I really see this as a legacy study that is going to live on through ECHO,” says Angal. “These types of studies don’t happen a lot because of the time and investment required.”

WEB EXTRA:

https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(19)30256-1/fulltext