Sudden unexpected death in infants under 3 months of age and vaccination status – a case-control study


Dr A.-P. Jonville-Béra, Department of Clinical Pharmacology, CRHU de Tours, 2 boulevard Tonnellé, F37044 Tours Cedex, France. Tel.: 33 2 47 47 80 29; Fax: 33 2 47 47 38 26; E-mail:


Aims  To determine whether DTPP+Hib vaccination (diphtheria, tetanus, pertussis, poliomyelitis +/− haemophilus) increased the risk of sudden unexpected death (SUD) in children under 3 months of age.

Methods  We conducted a multicentre case-control study in the 28 French ‘SIDS Centers’. Case selection was based on death labelled sudden infant death syndrome (SIDS) of an infant aged between 30 and 90 days. Three living controls were selected, matched for sex, gestational age and born immediately after the victim in the same maternity unit.

Results  We identified 114 cases of SUD aged between 30 and 90 days and 341 live controls matched for age and sex and born in the same maternity unit as the case. DTPP±Hib immunization did not increase the risk of SUD (OR 1.08) (95% CI 0.49, 2.36) in children under 3 months of age when adjusted for sleeping position, illness in the week before death, maternal tobacco consumption, birth weight, type of mattress, breastfeeding and sex. However, low birth-weight (6.53 [2.29, 18.9]), multiple birth (5.1 [1.76, 15.13]), no breastfeeding (1.77 [1.1, 2.85]), prone sleeping position (9.8 [5, 8, 18, 9]), soft mattress (3.26 [1.69, 6.29]), recent illness (3.44 [1.84, 6.41]) and parental smoking (1.74 [1.2, 2.96]) were confirmed as risk factors in early SIDS.

Conclusions  DTPP±Hib immunization is not a risk factor for early SUD. In this population, we found the same risk factors as described for SIDS.