Changing infants' sleep position increases risk of sudden infant death syndrome
Changing infants' sleep position increases risk of sudden infant death syndrome
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DOI：
10.1001/archpedi.153.11.1136
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发表时间：
1999-11-01
影响因子：
--
通讯作者：
Williams, S
中科院分区：
文献类型：
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作者：
Mitchell, EA;Thach, BT;Williams, S
目的：检查俯卧睡姿是否会增加婴儿猝死综合症 (SIDS) 的风险，特别是对于不习惯俯卧睡眠的婴儿。设计：一项为期 3 年（1987-1990）的病例对照研究。背景：新西兰全国性研究。受试者：485 名死于 SIDS 的婴儿和 1800 名对照组。主要结果指标：婴儿被分类为不习惯俯卧睡姿的婴儿。 如果他们通常的睡眠姿势不是俯卧并且他们在最后一次睡眠时处于俯卧状态。次要俯卧用于描述非俯卧但发现俯卧的婴儿。结果：通常和最后一次非俯卧的婴儿发生 SIDS 的风险最低（比值比 [OR]，1.0）；那些通常和最后俯卧的人风险增加（调整后的 OR，4.6；95% 置信区间，3.4-6.3）。不习惯俯卧位的婴儿的风险大大增加（调整后的 OR，19.3；95% 置信区间，8.2-44.8）。这些婴儿占所有 SIDS 死亡人数的 8% (31/386)。该组中 90% (28/31) 的婴儿被发现处于俯卧状态，而 71% (20/28) 的俯卧婴儿被发现脸朝下放在床上，这种姿势表明窒息是一种死亡机制。此外，138 名死于 SIDS 的婴儿最后被置于非俯卧状态。该组中有 47 名婴儿 (34%) 被发现俯卧（二次俯卧），其中 60% (28/47) 的婴儿被发现脸朝下埋在被褥中。该群体占所有 SIDS 死亡人数的 12%。这些婴儿中的大多数 (91% [43/47]) 通常采用非俯卧姿势。结论：仰卧睡眠的婴儿发生 SIDS 的风险最低，这支持了以下建议：这是健康婴儿的首选睡姿。在新西兰，20% 的婴儿猝死综合症死亡原因是缺乏俯卧睡姿经验。我们的研究结果表明，婴儿在俯卧睡眠（例如面朝下的位置）期间逃离潜在致命情况的能力可能会因缺乏俯卧睡眠经验而受到损害。将不习惯俯卧睡姿的婴儿置于俯卧位时应格外小心。
Objective: To examine whether the prone sleeping position may increase the risk for sudden infant death syndrome (SIDS), particularly in infants unused to prone sleep.Design: A 3-year (1987-1990) case-control study.Setting: Nationwide study in New Zealand.Subjects: Four hundred eighty-five infants who died of SIDS and 1800 controls.Main Outcome Measures: Infants were classified as unaccustomed to prone if their usual sleep position was nonprone and they were placed prone for the last sleep. Secondary prone was used to describe infants placed nonprone but found prone.Results: Infants usually and last placed nonprone were at the lowest risk for SIDS (odds ratio [OR], 1.0); those usually and last placed prone were at increased risk (adjusted OR, 4.6; 95% confidence interval, 3.4-6.3). Risk was greatly increased among infants unaccustomed to the prone position (adjusted OR, 19.3; 95% confidence interval, 8.2-44.8). These infants accounted for 8% (31/386) of all SIDS deaths. Ninety percent (28/31) of infants in this group were found prone, and 71% (20/28) of those found prone were found with their faces turned down into bedding-a position in which asphyxia has been implicated as a mechanism of death. In addition, 138 infants who died of SIDS were last placed nonprone. Forty-seven infants (34%) in this group were found prone (secondary prone), and 60% (28/47) of those found prone were found with their faces turned down into the bedding. This group accounted for 12% of all SIDS deaths. Most of these infants (91% [43/47]) were usually placed nonprone.Conclusions: Infants placed supine to sleep were at the lowest risk of SIDS, which supports the recommendation that this is the preferred sleeping position for healthy infants. Tn New Zealand, 20% of SIDS deaths involved lack of experience with the prone sleeping position. Our findings suggest the possibility that an infant's competence in escaping from potentially lethal situations during prone sleep (eg, the face-down position) may be impaired by inexperience in prone sleeping. Great caution should be exercised in placing infants unaccustomed to the prone sleeping position in the prone position.