INTERACTION BETWEEN BEDDING AND SLEEPING POSITION IN THE SUDDEN-INFANT-DEATH-SYNDROME - A POPULATION BASED CASE-CONTROL STUDY
INTERACTION BETWEEN BEDDING AND SLEEPING POSITION IN THE SUDDEN-INFANT-DEATH-SYNDROME - A POPULATION BASED CASE-CONTROL STUDY
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DOI：
10.1136/bmj.301.6743.85
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发表时间：
1990-07-14
影响因子：
105.7
通讯作者：
HALL, E
中科院分区：
文献类型：
--
作者：
FLEMING, PJ;GILBERT, R;HALL, E
目的：探讨婴儿睡姿、床上用品数量与婴儿猝死的关系。设计：所有婴儿突然意外死亡的研究和两个对照匹配的年龄和日期与每个索引案件。对照组婴儿的父母在指标婴儿死亡后72小时内接受了采访。收集了指数和对照婴儿的寝具、睡姿、取暖和近期疾病体征的信息。环境：一个确定的地理区域，包括埃文县的大部分和萨默塞特[英格兰，英国]的一部分。受试者：72名意外猝死的婴儿（其中67名死于婴儿猝死综合征）和144名对照婴儿。结果如下：与对照组婴儿相比，死于婴儿猝死综合征的婴儿更有可能倾向于睡觉（相对风险8.8; 95%置信区间7.0至11.0; p < 0.001），（相对危险度为1.14/tog 8以上; 1.03 ~ 1.28; p < 0.05），整夜开暖气（相对危险度为2.7; 1.4 ~ 5.2; p < 0.01）。这些差异在年龄较小的婴儿（小于70天）中不如年龄较大的婴儿明显。70天以上婴儿意外猝死的风险，总热阻大于10 tog的衣服和被褥增加了15.1倍（2.6至89.6）和25.2（3.7 ~ 169.0），与同年龄婴儿仰卧或侧卧及床重小于6 tg的婴儿比较。结论：过热和俯卧位与婴儿意外猝死的风险增加独立相关，特别是在70天以上的婴儿中。教育家长适当的保暖及婴儿睡姿，可减少婴儿猝死症的发生。
Objective: To determine the relation between sleeping position and quantity of bedding and the risk of sudden unexpected infant death. Design: A study of all infants dying suddenly and unexpectedly and of two controls matched for age and date with each index case. The parents of control infants were interviewed within 72 hours of the index infant''s death. Information was collected on bedding, sleeping position, heating, and recent signs of illness for index and control infants. Setting: A defined geographical area comprising most of the county of Avon and part of Somerset [England, UK]. Subjects: 72 Infants who had died suddenly and unexpectedly (of whom 67 had died from the sudden infant death syndrome) and 144 control infants. Results: Compared with the control infants the infants who had died from the sudden infant death syndrome were more likely to have been sleeping prone (relative risk 8.8; 95% confidence interval 7.0 to 11.0; p < 0.001), to have been more heavily wrapped (relative risk 1.14 per tog above 8 tog; 1.03 to 1.28; p < 0.05), and to have had the heating on all night (relative risk 2.7; 1.4 to 5.2; p < 0.01). These differences were less pronounced in the younger infants (less than 70 days) than the older ones. The risk of sudden unexpected death among infants older than 70 days, nursed prone, and with clothing and bedding of total thermal resistance greater than 10 tog was increased by factors of 15.1 (2.6 to 89.6) and 25.2 (3.7 to 169.0) respectively compared with the risk in infants of the same age nursed supine or on their side and under less than 6 tog of bedding. Conclusions: Overheating and the prone position are independently associated with an increased risk of sudden unexpected infant death, particulary in infants aged more than 70 days. Educating parents about appropriate thermal care and sleeping position of infants may help to reduce the incidence of the sudden infant death syndrome.