Home apnea monitoring and sudden infant death syndrome

Objective. To estimate the U.S. national prevalence of apnea monitor use by birth weight classification and to examine the relationship between the use of apnea monitors and the occurrence of Sudden Infant Death Syndrome (SIDS). Design and setting. Data obtained from the 1988 National Maternal and Infant Health Survey (NMIHS) were used. Prevalence estimates of apnea monitor use were obtained by weighting survey data, and the relationship between monitor use and SIDS was accomplished by a case-control analysis using SIDS deaths and live controls obtained from the NMIHS. Outcome measure. Weighted estimates of the prevalence of apnea monitor use and odds ratios for the odds of use of an apnea monitor among SIDS victims compared with the odds of use of an apnea monitor among living controls. Results. The national prevalence estimates for home apnea monitor use among birth weight strata of 500 to 1,499 g, 1,500 to 2,499 g, and 2,500 g or more for blacks were 19.9, 2.6, and 1.1% compared with 44.0, 8.8, and 1.2% for non-blacks. The only significant association between the use of apnea monitors and SIDS was for black 500- to 1,499-g infants. The adjusted odds ratio for SIDS among monitored black 500- to 1,499-g infants vs unmonitored infants was 3.93 (1.09, 14.17). Conclusions. This analysis suggests a marked difference in reported monitor use between U.S. black and non-black infants. In addition, black very low birth weight infants at highest risk for SIDS appear to be preferentially selected for monitoring. The protective effect of home apnea monitoring in this survey population is unclear.