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Although many people know that smoking is the leading cause of preventable death in the United States, it is less understood that some of these deaths are newborns.
Researchers do not really understand why cigarettes increase the risk of infant death, but they think it has something to do with the effects of nicotine on areas of the brain that interfere with the baby's sleep and breathing patterns. Smoking is also known to limit the flow of blood that carries oxygen and essential nutrients between the mother and the baby.
When smoking kills, it can happen quickly. In the United States, about 3,600 babies die suddenly each year for unknown reasons. The generic term for these unexplained deaths is SUID, or sudden unexpected deaths of infants, the best known being SIDS.
In a new study in pediatrics, The researchers estimated that if expectant mothers quit smoking, we could prevent 800 of these deaths.
For the paper, a collaboration between Microsoft and the Seattle Children's Research Institute, researchers analyzed the National Vital Statistics data from the Centers for Disease Control and Prevention for the 20 million births in the United States and more than 19,000 cases of sudden infant death that occurred between 2007 and 2011..
The Microsoft team has developed a computer model to examine the correlation between deaths and maternal smoking, taking into account various potential confounding factors – or other variables that may explain the increase in sudden deaths – including the level of race and the level of education of mothers.
"We wanted to make sure that the differences observed in the data could not be attributed to differences in race or differences in any of these other variables," said Tatiana Anderson, lead author of the study, PhD student. at the Seattle Children's Research Institute, "and we have again found this increased risk."
To be more specific, the researchers found that smoking during pregnancy – even a single cigarette – was associated with a risk of double risk of sudden death of the newborn during sleep.
And, said Anderson, "every extra cigarette has increased [sudden infant death] risk. So, smoking a pack a day triples your risk, and even if you quit before the first trimester, it still results in a 50% increase in the risk of sudden infant death. "
The study had certain limitations. On the one hand, researchers can only describe the correlations between variables that they examined, but not if one caused the other. In addition, they did not have data on mothers' alcohol consumption, which could have had an impact on smoking.
The overall risk of SUID is also low – less than 1% – and it is unclear how many deaths are actually caused by smoking. SUID is a generic term for unexplained newborn deaths. This includes the SIDS (meaning that an autopsy has been performed but the cause of death is unknown); unknown (there was no autopsy or known cause of death); and accidental death (a child was found in a dangerous sleep position, an autopsy was performed, but no cause of death is known).
"It's still a small percentage of mothers who smoke who have infants who die of SIDS or SUID," Anderson said. "We know statistically that a number of cases are caused by smoking, but not exactly which ones. They are always labeled as SIDS or SUID. "
But one thing is certain: a surprisingly high proportion of American women continue to smoke during pregnancy, which increases the risk of sudden infant death.
Too many American women smoke during pregnancy
According to the latest CDC data, in 2016, 7% of women who gave birth smoked while pregnant in the United States. For women aged 20 to 24, the smoking rate during pregnancy was 11%.
Some states have extremely high rates of maternal smoking. In West Virginia, a quarter of mothers smoke at the wait. Then come Kentucky, Montana, Vermont and Missouri, where more than 15% of moms smoke.
For John Kahan, the head of data analysis at Microsoft, a key player in the behind-the-scenes study, is too much.
In October 2003, Kahan and his wife welcomed their fourth child and first son, Aaron Matthew. "We were lucky enough to live a few hours without anyone knowing anything wrong," he recalls. "We have pictures of my parents and other children holding Aaron."
The baby looked perfectly healthy, as did Kahan's three daughters. But Kahan's son never left the hospital.
About six hours after his birth, Aaron stopped breathing. After three days, following the doctors' attempts to revive him, Aaron was pronounced dead.
To get close to Aaron's death, Kahan donated to charity over the years, even raising funds for SUID research by climbing Mount Kilimanjaro in 2016. " I wanted to make sure nobody would have lived, "he told Vox.
The same year, his personal tragedy took on a new meaning – and public -. Juan M. Lavista Ferres, a fellow scientist at Microsoft, saw a picture of Aaron in Kahan's office and asked about the boy. Kahan stifled, explaining that Aaron was dead.
As Kahan climbed Kilimanjaro, Lavista Ferres decided to download the publicly available CDC data on infant births and deaths in the United States and to use the vast array of machine learning tools from Microsoft to analyze the data.
One of the first studies of this data set is the pediatrics article on which Lavista Ferres is co-author. And it offers one of the most granular looks to date on smoking as a contributing factor to unexplained sudden infant death.
"Since Aaron's death, about 60,000 children have died in the United States and their parents and grandparents do not know why they died," Kahan said. In total, the SUID rate has been stable since the 1990s, after public health campaigns informing parents of the risks of putting their babies on their stomachs result in a 40% drop in the rate of SIDS in the United States.
Kahan and his wife have never smoked. The newspaper did not shed light on their situation. But Kahan hopes this will educate people about the problem and help others avoid the tragedy experienced by his family: "My mission is to ensure that no other parent suffers the sudden loss of a child. "
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