Racial Differences in Trends and Predictors of Infant Sleep Positioning in South Carolina, 1996–2007

Abstract

This paper examines racial differences in trends and predictors of prone and lateral infant sleep positioning among South Carolina mothers and infants. Pregnancy Risk Assessment Monitoring System data were used to analyze linear trends in prone, lateral, and supine infant sleep positioning among 14,648 mother-infant pairs from 1996 to 2007. Logistic regression models were used to examine the predictors of prone and lateral positioning among 9,015 mother-infant pairs from 2000 to 2007. From 1996 to 2007, white infants experienced a reduction in both prone and lateral positioning and an increase in supine positioning (28.2-66.7%), while black infants had smaller decreases in prone and lateral positioning and a smaller increase in supine positioning (22.6-47.1%) than white infants. Compared to births in 2000-2005, births after the explicit recommendation that infants not be placed in the lateral sleep position (2006-2007) were associated with decreased odds of lateral positioning among white infants (odds ratio [OR]: 0.66; 95% confidence interval [CI]: 0.51, 0.87) but not among black infants. The significant predictors of white infants being placed in the prone position were different from the predictors for black infants. Additionally, with regard to lateral sleep positioning, more significant predictors were observed among white infants than black infants. These findings suggest that efforts are warranted to increase the prevalence of supine sleep positioning, especially among black infants. Race-specific programs may efficiently reduce non-supine sleep positioning to help narrow racial gaps in sudden infant death syndrome.

A Comparison of Community and Clinic Baby Showers to Promote Safe Sleep for Populations at High Risk for Infant Mortality

“…15 To reduce infant mortality, further education about safe sleep, specifically aimed at African American and low-income populations, is needed. [16][17][18][19] The education must include information about safe sleep position as well as safe sleeping environment. 6 Research suggests that reading materials do not influence African American mothers' choice in sleep position for their infants.…”

Incidence and determinants of sudden infant death syndrome: a population-based study on 37 million births

“…According to a study by Smith et al looking at race and infant sleep positioning in South Carolina, 60.2% of white, non-Hispanic infants were found to be placed in the supine sleep position whereas only 38.8% of black, non-Hispanic infants were positioned supinely in 2004. [26] In another study by Colson et al [27] mothers of black race were found to be 3 times more likely to practice infant bed sharing.…”

Prevailing head position to one side in early infancy—A population‐based study

“…3,5 Interestingly, having a non-native Dutch father was associated with a lower risk of PHP, which supports the suggestion that ethnic background and cultural habits may play a role in the genesis of PHP. 18,26 PHP was only associated with two perinatal risk factors:…”