Head covering - a major modifiable risk factor for sudden infant death syndrome: a systematic review

被引:63
作者
Blair, P. S. [1 ]
Mitchell, E. A. [2 ]
Heckstall-Smith, E. M. A. [1 ]
Fleming, P. J. [1 ]
机构
[1] Univ Bristol, Inst Child Life & Hlth, Dept Clin Sci, Bristol BS8 1TH, Avon, England
[2] Univ Auckland, Dept Paediat, Auckland, New Zealand
关键词
D O I
10.1136/adc.2007.136366
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Background: Some victims of sudden infant death syndrome ( SIDS) are found with their heads covered with bedclothes, but the significance of this is uncertain. The aim of this review is to describe the prevalence of head covering, the magnitude of the risk and how far the suggested causal mechanisms agree with current epidemiological evidence. Methods: Systematic review of population-based age-matched controlled studies. Results: Controlled observations of head covering for the final sleep were found in 10 studies. The pooled prevalence in SIDS victims was 24.6% (95% CI 22.3% to 27.1%) compared to 3.2% (95% CI 2.7% to 3.8%) among controls. The pooled univariate odds ratio (OR) was 9.6 ( 95% CI 7.9 to 11.7) and the pooled adjusted OR from studies mainly conducted after the fall in SIDS rate was 16.9 (95% CI 12.6 to 22.7). The risk varied in strength but was significant across all studies. In a quarter of cases and controls head covering had occurred at least once previously (pooled adjusted OR=1.1; 95% CI 0.9 to 1.4). The population attributable risk (27.1%; 95% CI 24.7% to 29.4%) suggests avoiding head covering might reduce SIDS deaths by more than a quarter. Conclusions: The epidemiological evidence does not fully support postulated causal mechanisms such as hypoxia, hypercapnoea and thermal stress, but neither does it support the idea that head covering is part of some terminal struggle. Head covering is a major modifiable risk factor associated with SIDS deaths and parental advice to avoid this situation should be emphasised.
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收藏
页码:778 / 783
页数:6
相关论文
共 69 条
[1]   Accidental mechanical suffocation in infants [J].
Abramson, H .
JOURNAL OF PEDIATRICS, 1944, 25 :404-413
[2]  
[Anonymous], REV MAN REVMAN VERS
[3]  
ARMITAGE P, 1990, STAT METHODS MED RES, P462
[4]   Changes in the epidemiological pattern of sudden infant death syndrome in southeast Norway, 1984-1998:: implications for future prevention and research [J].
Arnestad, M ;
Andersen, M ;
Vege, Å ;
Rognum, TO .
ARCHIVES OF DISEASE IN CHILDHOOD, 2001, 85 (02) :108-115
[5]   Differences in infant and parent behaviors during routine bed sharing compared with cot sleeping in the home setting [J].
Baddock, SA ;
Galland, BC ;
Bolton, DPG ;
Williams, SM ;
Taylor, BJ .
PEDIATRICS, 2006, 117 (05) :1599-1607
[6]   DEATH-SCENE INVESTIGATION IN SUDDEN INFANT DEATH [J].
BASS, M ;
KRAVATH, RE ;
GLASS, L .
NEW ENGLAND JOURNAL OF MEDICINE, 1986, 315 (02) :100-105
[7]   SUDDEN-INFANT-DEATH-SYNDROME RELATED TO CLIMATE [J].
BEAL, S ;
PORTER, C .
ACTA PAEDIATRICA SCANDINAVICA, 1991, 80 (03) :278-287
[8]   ACCIDENTAL DEATH OR SUDDEN-INFANT-DEATH-SYNDROME [J].
BEAL, SM ;
BYARD, RW .
JOURNAL OF PAEDIATRICS AND CHILD HEALTH, 1995, 31 (04) :269-271
[9]   Sudden infant death syndrome in South Australia 1968-97. Part I: Changes over time [J].
Beal, SM .
JOURNAL OF PAEDIATRICS AND CHILD HEALTH, 2000, 36 (06) :540-547
[10]  
BEAL SM, 1983, SUDDEN INFANT DEATH, P15