The Contribution of Prone Sleeping Position to the Racial Disparity in Sudden Infant Death Syndrome: The Chicago Infant Mortality Study

Hauck, Fern R.; Moore, Cathryn Merrick; Herman, Stanislaw M.; Donovan, Mark; Kalelkar, Mitra B.; Christoffel, Katherine Kaufer; Hoffman, Howard J.; Rowley, D.

doi:10.1542/peds.110.4.772

Cited by 128 publications

(76 citation statements)

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“…Hauck, et al, in a case-control study of SIDS, found that 58% of African-American infants bedshared, compared with 29.2% of non-African-American infants. (30) Similarly, in a retrospective population-based cohort of sudden unexpected infant deaths, Unger et al found bedsharing deaths to be nearly twice as common in African American infants. (24) Other studies have found bedsharing to be linked to measures of poverty.…”

Section: Discussionmentioning

confidence: 96%

Infant Sleep Location: Associated Maternal and Infant Characteristics with Sudden Infant Death Syndrome Prevention Recommendations

Colson

Corwin

et al. 2008

The Journal of Pediatrics

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Objective-To identify factors associated with infant sleep location.Methods-Demographic information and infant care practices were assessed for 708 mothers of infants ages 0 to 8 months at Women, Infants and Children centers (WIC). Generalized linear latent mixed models were constructed for the outcome, sleeping arrangement last night (bedsharing with infants vs. roomsharing without bedsharing, and versus sleeping in separate rooms).Results-Two-thirds of the mothers were black. 48.6% roomshared without bedsharing; 32.5% bedshared; and 18.9% slept in separate rooms. Compared with infants who slept in separate rooms, infants who roomshared without bedsharing were more likely to be Hispanic (OR 2.58,) and younger (3.66 and 1.74 times more likely for infants 0-1 month and 2-3 months old respectively as compared with older infants). Compared with infants who bedshared, those that roomshared without bedsharing were more likely to be 0-1 month old (1.57, 1.05-2.35), and less likely to be black (0.43, 0.26-0.70) or have a teenage mother (0.37, 0.23-0.58).Conclusions-Approximately one-third of mothers and infants bedshare despite increased risk of sudden infant death syndrome (SIDS). The factors associated with bedsharing are also associated with SIDS likely rendering infants with these characteristics at high risk for SIDS. Keywords infants; SIDS; bed sharingThe incidence of SIDS in the US has declined 50% since 1992, when the American Academy of Pediatrics (AAP) first recommended that infants be placed in a nonprone position for sleep.(1) Despite the tremendous success of the subsequent Back to Sleep campaign, the initial decline in SIDS rates has leveled off in the last 5 years. Washington, DC 20010, Tel: 202-476-3931, Fax: 202-476-3386, lfu@cnmc As the rate of prone positioning has declined, other previously unrecognized risk factors for sudden unexplained infant death have emerged in recent epidemiologic studies. Despite the fact that bedsharing between an infant and adult facilitates breastfeeding and enhances parent-infant interactions,(6, 7) this sleeping arrangement has been identified in epidemiologic studies as being hazardous in certain situations, particularly when one or both parents are smokers,(8-12) on excessively soft surfaces, such as waterbeds, sofas, and armchairs, (9,10,(13)(14)(15) or when the infant is less than 2-3 months of age. (9,12,(14)(15)(16)(17) In addition, there is an increased risk for sudden unexpected infant death when there are multiple bedsharers(13) and when bedsharing occurs for the entire night.(9, 11) The risk for infant death may also be increased when the bedsharer has consumed alcohol or is overtired. Because of this increased emphasis on the importance of the infant's sleep location, it is necessary to understand factors associated with bedsharing, roomsharing without bedsharing, and solitary sleeping (i.e., infant sleeps in a separate room from parents). The primary aim of this study was to determine the maternal and infant characteristics associated with each of ...

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Section: Discussionmentioning

confidence: 96%

Infant Sleep Location: Associated Maternal and Infant Characteristics with Sudden Infant Death Syndrome Prevention Recommendations

Colson

Corwin

et al. 2008

The Journal of Pediatrics

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“…Our results substantiate what other studies have found regarding racial and ethnic differences in the leading causes of infant death. 8,[19][20][21] Several studies have found ethnic differences in dietary (folic acid intake), 22 genetic, 23 environmental, 20 and health service factors, 19,24 and these variations may lead to ethnic differences in cause of infant death. In the case of SIDS, the Chicago Infant Mortality Study 20 found that black women were more likely to put their in- Cause of Death (ICD-9-CM) Rate Per 100 000 Live Births for Neonatal (N) and Postneonatal (P) Mortality, by Maternal Ethnicity: California, 1995California, -1997 Cause of Death (ICD-9-CM Code)…”

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confidence: 99%

Ethnic Differences in Neonatal and Postneonatal Mortality

Hessol

Fuentes-Afflick

2005

Pediatrics

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ABSTRACT. Objective. Ethnic disparities in infant mortality have been consistently documented in the United States, but these disparities are poorly understood. Although the infant mortality rate in the United States has fallen to record low rates, since 1971 the ethnic disparity between black and white infants has remained unchanged or increased. In 2001, the infant mortality rate among black infants was ϳ2.5 times higher than the rate among white and Hispanic infants. The objective of this study was to identify ethnic differences in neonatal and postneonatal mortality as well as the causes and risk factors among infants born in California.Methods. Secondary analysis was performed of 1 277 393 singleton infants live-born to black, Latina, and white women from the California linked birth-infant death certificate from 1995 to 1997. The dependent variables were infant death (defined as an infant who died in the first year of life [death <365 days]), neonatal death (death during the first 27 days of life), and postneonatal death (death between 28 and 364 days of life). Causespecific neonatal and postneonatal infant mortality rates (per 100 000 live births) were calculated for each ethnic group. 2 and exact test statistics were used to compare the distribution of maternal and infant characteristics and cause-of-death rates by maternal ethnicity. Logistic regression analysis was used to compute odds ratios (ORs) and 95% confidence intervals (CIs) to estimate the relationship between maternal ethnicity, maternal and infant factors, and risk of infant mortality.Results. In both the neonatal and postneonatal periods, black women had higher infant mortality rates than Latina or white women for conditions originating in the perinatal period (including respiratory distress syndrome) and symptoms, signs, and ill-defined conditions (including sudden infant death syndrome). After adjusting for maternal and infant characteristics, there were no significant ethnic differences for neonatal mortality. For postneonatal mortality, black women had a higher risk (OR: 1.25; 95% CI: 1.10-1.42) and Latina women had a lower risk (OR: 0.80; 95% CI: 0.71-0.89) compared with white women after adjusting for maternal and infant factors. In analyses of all ethnic groups combined, as well as ethnic-specific analyses, the strongest predictors of neonatal and postneonatal death were infant birth weight of <2499 g and gestational age of <33 weeks.Conclusions. Causes of infant mortality and risk factors for infant mortality differed by maternal ethnicity, indicating a need to tailor prevention and education efforts, especially during the postneonatal period. To achieve national infant mortality goals, health professionals and policy makers should continue to emphasize the importance of early and continuous prenatal care and develop new strategies to reduce the incidence of low birth weight and premature infants. Ethnic-specific approaches may be needed to further reduce infant mortality rates and achieve our national goal to eliminate ethnic dispar...

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“…The prone and side sleeping positions increase the risk of sudden and unexplained infant death during any sleep, including napping. 30 However, caregivers may be less aware or less concerned about the infant' s sleeping position if they believe that they will be awake and observing the infant. 31 Anecdotal data suggest that parents often place their infants on sofas when they will be in the same room and want the infant within sight (R.Y.M., unpublished data).…”

Section: Discussionmentioning

confidence: 99%

Sofas and Infant Mortality

2014

PEDIATRICS

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WHAT'S KNOWN ON THIS SUBJECT: Sleeping on a sofa increases the risk of sudden and unexpected infant death.WHAT THIS STUDY ADDS: Infant deaths on sofas are associated with nonsupine placement, being found in side position, surface sharing, changing sleep location, and experiencing prenatal tobacco exposure. These results may help explain why sofa sleeping is hazardous for infants. abstract OBJECTIVE: Sleeping on sofas increases the risk of sudden infant death syndrome and other sleep-related deaths. We sought to describe factors associated with infant deaths on sofas. METHODS:We analyzed data for infant deaths on sofas from 24 states in 2004 to 2012 in the National Center for the Review and Prevention of Child Deaths Case Reporting System database. Demographic and environmental data for deaths on sofas were compared with data for sleep-related infant deaths in other locations, using bivariate and multivariable, multinomial logistic regression analyses. RESULTS:A total of 1024 deaths on sofas made up 12.9% of sleeprelated infant deaths. They were more likely than deaths in other locations to be classified as accidental suffocation or strangulation (adjusted odds ratio [aOR] 1.9; 95% confidence interval [CI], 1.6-2.3) or ill-defined cause of death (aOR 1.2; 95% CI, 1.0-1.5). Infants who died on sofas were less likely to be Hispanic (aOR 0.7; 95% CI, 0.6-0.9) compared with non-Hispanic white infants or to have objects in the environment (aOR 0.6; 95% CI, 0.5-0.7) and more likely to be sharing the surface with another person (aOR 2.4; 95% CI, 1.9-3.0), to be found on the side (aOR 1.9; 95% CI, 1.4-2.4), to be found in a new sleep location (aOR 6.5; 95% CI, 5.2-8.2), and to have had prenatal smoke exposure (aOR 1.4; 95% CI, 1.2-1.6). Data on recent parental alcohol and drug consumption were not available. CONCLUSIONS:The sofa is an extremely hazardous sleep surface for infants. Deaths on sofas are associated with surface sharing, being found on the side, changing sleep location, and experiencing prenatal tobacco exposure, which are all risk factors for sudden infant death syndrome and sleep-related deaths.

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The Contribution of Prone Sleeping Position to the Racial Disparity in Sudden Infant Death Syndrome: The Chicago Infant Mortality Study

Cited by 128 publications

References 51 publications

Infant Sleep Location: Associated Maternal and Infant Characteristics with Sudden Infant Death Syndrome Prevention Recommendations

Infant Sleep Location: Associated Maternal and Infant Characteristics with Sudden Infant Death Syndrome Prevention Recommendations

Ethnic Differences in Neonatal and Postneonatal Mortality

Sofas and Infant Mortality

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