Factors associated with the transition to nonprone sleep positions of infants in the United States - The National Infant Sleep Position Study
Factors associated with the transition to nonprone sleep positions of infants in the United States - The National Infant Sleep Position Study
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DOI：
10.1001/jama.280.4.329
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发表时间：
1998-07-22
影响因子：
120.7
通讯作者：
Corwin, MJ
中科院分区：
文献类型：
--
作者：
Willinger, M;Hoffman, HJ;Corwin, MJ
背景。-研究表明俯卧睡姿(仰卧)与婴儿猝死综合征(SID)之间存在很强的相关性。1992年，美国儿科学会建议婴儿侧卧(侧卧)或仰卧(仰卧)以降低婴儿猝死综合征的风险，并在1994年发起了全国性的公共教育运动“重返睡眠”。目的-为了确定美国8个月以下婴儿的典型睡眠姿势，这些建议后发生的变化，以及与婴儿俯卧或仰卧放置有关的因素。设计。-年度全国代表性电话调查。设置。-美国48个相邻的州。参与者。-1992至1996年间最后7个月内出生的婴儿的夜间照顾者，每年进行约1000次访谈。主要结果衡量标准。-婴儿通常被放置在睡觉的位置，以及在夜间睡眠检查时婴儿最常被发现的位置。结果。-在每一波调查中，97%的受访者通常将婴儿放在特定的位置睡觉。在运动之前的1992年，70%的照顾者将婴儿放在俯卧位，但在1996年只有24%，仰卧位和侧卧位在此期间分别从1992年的13%增加到1996年的35%，从1992年的15%增加到1996年的39%。有意义的预测因素包括黑人(优势比[OR]，2.34；95%可信区间[CI]，1.68-3.26)，母亲年龄20-29岁(OR，1.28；95%CI，1.09-1.50)，大西洋中部地区(OR，1.41；95%CI，1.12-1.78)或南部各州(OR，1.47；95%CI，1.22-1.70)，母亲有前一个孩子(OR，1.68；与其他年龄组相比，8-15周龄的婴儿随着时间的推移更有可能被置于非倾向性状态。俯卧位的大多数危险因素与仰卧位的方向相反。结论：1992至1996年间，婴儿俯卧位的患病率下降了66%，尽管无法证明因果关系，但在此期间，小岛屿发展中国家的发病率下降了约38%。为了进一步减少俯卧位睡眠，促进仰卧睡姿的努力应该针对俯卧位的高危人群。
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.