Vaping During Pregnancy and SUDI Risk: New Zealand Case-Cohort Study

This project addresses the tragic reality of Sudden Unexpected Death in Infancy (SUDI) in Aotearoa New Zealand. Each year, 40-60 babies die from SUDI. This rate is significantly higher than in many Northern European countries, where, for the same population size, only 8-12 deaths would be expected annually. Crucially, approximately 70% of these devastating deaths occur among Māori whanau, highlighting one of New Zealand's starkest health inequities.

While past efforts have dramatically reduced SUDI, this decline has plateaued despite decreasing maternal smoking rates (a known key risk factor). We suggest that vaping may be a new emerging risk factor. Nicotine, from either smoking or vaping, crosses the placenta and has been linked to adverse infant outcomes like low birth weight and reduced breastfeeding duration. With 25% of New Zealand adults now regularly vaping, compared to 8.4% who smoke, understanding this potential link is critical.

Our research will use a unique dataset from Whānau Āwhina Plunket, covering approximately 170,000 infants, which includes information on maternal vaping during pregnancy and the postnatal period, alongside infant sleep environments. By linking this data with confirmed SUDI cases, we will determine if maternal vaping, smoking, or dual use increases SUDI risk.

This study offers a vital opportunity to generate robust evidence that will inform prevention strategies, support safer pregnancy choices for whānau across Aotearoa as we all work towards a future where fewer families experience such profound loss.