The Journal of Pediatrics
Volume 140, Issue 2 , Pages 205-209, February 2002

Lung tissue concentrations of nicotine in sudden infant death syndrome (SIDS)☆☆★★

Division of Clinical Pharmacology and Toxicology, Hospital for Sick Children, University of Toronto, Ontario, Canada, and the Division of Forensic Pathology, Department of Pathology, University of Maryland School of Medicine, Baltimore

Received 25 April 2001; received in revised form 5 September 2001 and 16 November 2001; accepted 28 November 2001.

Abstract 

Objective: To compare lung concentrations of nicotine and cotinine in cases of sudden infant death syndrome (SIDS) and controls. Design/methods: We measured lung tissue concentrations of nicotine and cotinine in SIDS (n = 44) and non-SIDS cases (n = 29) stratified according to household smoking status. Results: When all the SIDS and non-SIDS cases were compared regardless of smoking status, there was a significantly higher nicotine concentration in the SIDS cases than in the non-SIDS cases, (P = .0001). Upon stratifying for smoking status, there was a nonsignificant trend toward more nicotine in SIDS versus non-SIDS lungs that had come from a reported smoking environment. In the nonsmoking group, there were significantly higher nicotine concentrations in SIDS than non-SIDS cases (P = .001). Conclusions: Children who died from SIDS tended to have higher concentrations of nicotine in their lungs than control children, regardless of whether smoking was reported. These results are based on an objective, biochemical test rather than history, and they further support the relationship between environmental tobacco smoke and the risk of SIDS. (J Pediatr 2002;140:205-9)

Abbreviations:  ETS , Environmental tobacco smoke, PMTI , Postmortem time interval, SIDS , Sudden infant death syndrome

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 Supported in part by the Brain and Tissue Bank for Developmental Disorders (NICHHD contract N01-HD8-3283), and the Canadian Institutes for Health Research. Dr McMartin was supported by a studentship of the Canadian Foundation for the Study of Infant Deaths.

☆☆ Dr Koren is a Senior Scientist of the Canadian Institutes for Health Research and holder of the Duchemay and Canadian Foundation for Women's Health Chair in Better Pharmacotherapy During Pregnancy and Lactation.

 Deceased.

★★ Reprint requests: Gideon Koren, MD, Division of Clinical Pharmacology and Toxicology, Hospital for Sick Children, 555 University Ave, Toronto, Ontario, Canada M5G 1X8.

PII: S0022-3476(02)56804-9

doi:10.1067/mpd.2002.121937

The Journal of Pediatrics
Volume 140, Issue 2 , Pages 205-209, February 2002