I Did Not Take Drugs During My
Why all the Talk About Drugs During Pregnancy and SIDS?
Thomas G. Keens, M.D., and Sally L. Davidson Ward, M.D.
Childrens Hospital Los Angeles
University of Southern California School of Medicine
Reprinted with permission
Most babies who died from SIDS were born after normal pregnancies, from healthy mothers
who were not sick and who did not use any illicit drugs during their pregnancy. Thus,
exposure of the baby to drugs during pregnancy is not a cause of SIDS.
However, SIDS is the most common cause of death in infants between the ages of one
month and one-year, yet its etiology remains unknown. It has been noticed that infants
born to mothers who abused drugs during pregnancy (infants of substance abusing mothers;
ISAM) have an increased risk of dying from SIDS compared to babies who were not ISAM. In
general, the risk of SIDS in an ISAM is 8-10 times increased over that of the general
population. Thus, the majority of babies who die from SIDS are not ISAM, but if a baby was
exposed to maternal drug use during the pregnancy, the risk for that baby is markedly
The increased SIDS risk in ISAM has two implications. First, ISAM may require special
medical attention because of their increased risk for SIDS. Second, ISAM provide
researchers with an important research tool to try to understand SIDS better.
We know that ISAM have an increased risk for SIDS. We do not know the cause of SIDS. If
we could study ISAM to determine what is different about these babies, it might give us
clues about what might cause SIDS, even in babies who are not ISAM. Consequently, a number
of research studies have been performed in ISAM. Many of these focus on how babies
breathe, how sleep and breathing interact, and how these infants respond to potentially
dangerous situations during sleep, such as apnea or low oxygen. In general, ISAM do show
abnormalities in their breathing and protective physiologic responses. Research is still
ongoing in an attempt to understand how this might relate to SIDS. However, many
researcher believe that these studies in ISAM will improve our understanding about how
SIDS victims might die.
The fact that ISAM are used in SIDS research does not mean that researchers believe
that all SIDS victims died because of drug exposure during pregnancy. In fact, we know
that the overwhelming majority of SIDS victims were not ISAM. However, the research in
ISAM may provide clues to all SIDS, even that which occurs in babies not exposed to
maternal drug use during pregnancy.
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