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After adjustment for potential confounders, prone and side sleeping positions, maternal smoking, and the joint exposure to bed sharing and maternal smoking were associated with statistically significant increased risk of SIDS. A change from the side to the supine sleeping position could result in a substantial reduction in SIDS. Maternal smoking is common in New Zealand and with the reduction in the prevalence of prone sleeping position is now the major risk factor in this country. However, smoking behavior has been difficult to change. Bed sharing is also a major factor but appears only to be a risk to infants of mothers who smoke. Addressing bed sharing among mothers who smoke could reduce SIDS by at least one third. Breastfeeding did not appear to offer a statistically significant reduction in SIDS risk after adjustment of potential confounders, but as breastfeeding rates are comparatively good in New Zealand, this result should be interpreted with caution as the power of this study to detect a benefit is small.

New Zealand's high mortality rate from sudden infant death syndrome (SIDS) prompted the development of the New Zealand Cot Death Study. A report of the analysis of the data from the first year has been published. This report now gives the major identified risk factors from the full 3 year data set. In this case-control study there were 485 infants who died from SIDS in the post-neonatal age group, and 1800 control infants, who were a representative sample of all hospital births in the study region. Obstetric records were examined and parental interviews were completed in 97.5% and 86.9% of subjects, respectively. As expected many risk factors for SIDS were confirmed including: lower socio-economic status, unmarried mother, young mother, younger school-leaving age of mother, younger age of mother at first pregnancy, late attendance at antenatal clinic, non-attendance at antenatal classes, Maori, greater number of previous pregnancies, the further south the domicile, winter, low birthweight, short gestation, male infant and admission to a special care baby unit. In addition, however, we identified four risk factors that are potentially amenable to modification.(ABSTRACT TRUNCATED AT 250 WORDS)

Objectives-To investigate why sharing the bed with an infant is a not consistent risk factor for the sudden infant death syndrome in ethnic subgroups in New Zealand and to see if the risk of sudden infant death associated with this practice is related to other factors, particularly maternal smoking and alcohol consumption.Design-Nationwide case-control study. 0-44 to 2-18). Neither maternal alcohol consumption nor the thermal resistance of the infant's clothing and bedding interacted with bed sharing to increase the risk ofsudden infant death, and alcohol was not a risk factor by itself.Conclusion-Infant bed sharing is associated with a significantly raised risk of the sudden infant death syndrome, particularly among infants of mothers who smoke. The interaction between maternal smoking and bed sharing suggests that a mechanism involving passive smoking, rather than the previously proposed mechanisms of overlaying and hyperthermia, increases the risk of sudden infant death from bed sharing.

AimTo examine the associations between connectedness to family and friends, and school engagement, and selected health compromising and health promoting behaviours in a sample of New Zealand adolescents.MethodsA web‐based survey was designed and administered to a random sample of 652 Year 11 students aged 16 years from all Dunedin (NZ) high schools between 30th July and 31st October 2001. Connectedness to family and friends, and school engagement were assessed, together with reports of various health compromising and health promoting behaviours. Logistic regression was used to determine the extent to which these family, friends and school variables were related to health compromising and health promoting behaviours.ResultsSchool engagement was strongly related to both low levels of health compromising and high levels of health promoting behaviours. Connectedness to family was associated primarily with fewer reports of suicidal ideation and increased reports of physical activity. Connectedness to friends was associated in the main with increased reports of health compromising behaviours.ConclusionThis study reinforces the importance of school and family as support networks for young people. School may well play an especially important role in health promotion among young people. The mechanisms by which engagement with school operates need to be explored further.