Factors associated with the transition to nonprone sleep positions of infants in the United States - The National Infant Sleep Position Study

被引:184
作者
Willinger, M
Hoffman, HJ
Wu, KT
Hou, JR
Kessler, RC
Ward, SL
Keens, TG
Corwin, MJ
机构
[1] NICHHD, Ctr Res Mothers & Children, Pregnancy & Perinatol Branch, NIH, Bethesda, MD 20892 USA
[2] Natl Inst Deafness & Other Commun Disorders, Epidemiol Stat & Data Syst Branch, NIH, Bethesda, MD USA
[3] Univ So Calif, Childrens Hosp Los Angeles, Sch Med, Div Neonatol & Pediat Pulmonol, Los Angeles, CA USA
[4] Harvard Univ, Sch Med, Dept Hlth Care Policy, Boston, MA 02115 USA
[5] Boston Univ, Med Ctr, Sch Med, Dept Pediat, Boston, MA 02118 USA
来源
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION | 1998年 / 280卷 / 04期
关键词
D O I
10.1001/jama.280.4.329
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Context.-Studies have demonstrated strong associations between the prone sleep position (on the stomach) and sudden infant death syndrome (SIDS), In 1992, the American Academy of Pediatrics recommended that infants be placed to sleep laterally (on their side) or supine (on their back) to reduce SIDS risk, and in 1994, the national public education campaign "Back to Sleep" was launched. Objective.-To determine the typical sleep position of infants younger than 8 months in the United States, the changes that occurred after these recommendations, and the factors associated with the placement of infants prone or supine. Design.-Annual nationally representative telephone surveys. Setting.-The 48 contiguous states of the United States. Participants.-Nighttime caregivers of infants born within the last 7 months between 1992 and 1996, Approximately 1000 interviews were conducted per year. Main Outcome Measures.-The position the infant was usually placed in for sleep, and the position the infant was most commonly found in when checked during the night's sleep. Results.-Ninety-seven percent of respondents in each wave of the survey usually placed their infant to sleep in a specific position. Infants were placed in the prone position by 70% of caregivers in 1992, prior to the campaign, but only 24% in 1996, Supine and lateral placements increased during this time period, from 13% in 1992 to 35% in 1996 and from 15% in 1992 to 39% in 1996, respectively. Significant predictors of prone placement included maternal race reported as black (odds ratio [OR], 2.34; 95% confidence interval [CI], 1.68-3.26), mother's age 20 to 29 years (OR, 1.28; 95% CI, 1.09-1.50), region reported as the mid-Atlantic (OR, 1.41; 95% CI, 1.12-1.78) or southern states (OR, 1.47; 95% CI, 1.22-1.70), mothers with a previous child (OR, 1.68; 95% CI, 1.43-1.97), and infants younger than 8 weeks (OR, 0.63; 95% CI, 0.46-0.85), Infants aged 8 to 15 weeks were significantly more likely to be placed nonprone over time compared with the other age groups. Most of the risk factors for prone were significantly related in the opposite direction to supine placement. Conclusions.-The prevalence of infants placed in the prone sleep position declined by 66% between 1992 and 1996, Although causality cannot be proved, SIDS rates declined approximately 38% during this period. To achieve further reduction in prone sleeping, efforts to promote the supine sleep position should be aimed at groups at high risk for prone placement.
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页码:329 / 335
页数:7
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