Trends and Factors Associated With Infant Bed Sharing, 1993-2010 The National Infant Sleep Position Study
Trends and Factors Associated With Infant Bed Sharing, 1993-2010 The National Infant Sleep Position Study
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DOI：
10.1001/jamapediatrics.2013.2560
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发表时间：
2013-11-01
期刊：
影响因子：
26.1
通讯作者：
Corwin, Michael J.
中科院分区：
文献类型：
--
作者：
Colson, Eve R.;Willinger, Marian;Corwin, Michael J.
重要性 婴儿共用床与婴儿猝死综合症或婴儿意外睡眠相关死亡之间存在密切关联。婴儿中与睡眠相关的意外死亡的发生率似乎在增加。目的 确定 1993 年至 2010 年与婴儿同床相关的趋势和因素，包括医生对同床建议的关联。设计国家婴儿睡眠姿势研究，通过年度电话调查进行。设置 48 个相邻州。参与者 每次调查后 7 个月内出生的婴儿的夜间护理人员。每年完成大约 1000 次访谈。 主要结果和措施 婴儿共用床是一种常见做法。结果 在 18 986 名参与者中，11.2% 表示婴儿共用床是一种常见做法。床位共享从 1993 年 (6.5%) 增加到 2010 年 (13.5%)。尽管从 1993 年到 2000 年，白人受访者的床位共享显着增加 (P < .001)，但 2001 年到 2010 年的增加并不显着 (P = .48)。黑人和西班牙裔受访者表示，在整个研究期间，床铺共享有所增加，早期和后期之间没有差异（分别为 P = 0.63 和 P = 0.77）。考虑到研究年份后，与婴儿床共用增加相关的因素包括：与大学或更高学历相比，母亲的教育水平低于高中（调整后的比值比，1.42 [95% CI，1.12-1.79]）；与白人相比，黑人（3.47 [2.97-4.05]）、西班牙裔（1.33 [1.10-1.61]）和其他（2.46 [2.03-2.97]）母系种族或民族；家庭收入低于 20 000 美元 (1.69 [1.44-1.99]) 和 20 000 美元至 50 000 美元 (1.29 [1.14-1.45]) 与高于 50 000 美元的家庭收入相比；与中西部相比，居住在西部 (1.61 [1.38-1.88]) 或南部 (1.47 [1.30-1.66])；与 16 周或以上婴儿相比，小于 8 周 (1.45 [1.21-1.73]) 或 8 至 15 周 (1.31 [1.17-1.45]) 的婴儿；与足月相比，早产 (1.41 [1.22-1.62])。近 46% 的参与者表示曾与医生讨论过床位共享问题。与那些没有接受医生建议的人相比，那些报告医生持消极态度的人不太可能让婴儿共用一张床（调整后的比值比，0.66 [95% CI，0.53-0.82]），而中立态度与增加床位共享相关（1.38 [1.05-1.80]）。 结论和相关性我们发现，在整个研究期间，婴儿床位共享持续增加黑色和 西班牙裔婴儿表明，目前美国儿科学会关于同床的建议并未得到普遍遵循。与婴儿共用床相关的因素可能有助于评估广泛干预措施对改变行为的影响。
IMPORTANCE A strong association between infant bed sharing and sudden infant death syndrome or unintentional sleep-related death in infants has been established. Occurrences of unintentional sleep-related deaths among infants appear to be increasing.OBJECTIVES To determine the trends and factors associated with infant bed sharing from 1993 through 2010, including the association of physician advice on bed sharing.DESIGN National Infant Sleep Position study conducted with annual telephone surveys.SETTING The 48 contiguous states.PARTICIPANTS Nighttime caregivers of infants born within 7 months of each survey administration. Approximately 1000 interviews were completed annually.MAIN OUTCOMES AND MEASURES Infant bed sharing as a usual practice.RESULTS Of 18 986 participants, 11.2% reported an infant sharing a bed as a usual practice. Bed sharing increased from 1993 (6.5%) to 2010 (13.5%). Although bed sharing increased significantly among white respondents from 1993 to 2000 (P < .001), the increase from 2001 to 2010 was not significant (P = .48). Black and Hispanic respondents reported an increase in bed sharing throughout the study period, with no difference between the earlier and later periods (P = .63 and P = .77, respectively). After accounting for the study year, factors associated with increase in infant bed sharing as a usual practice included maternal educational level of less than high school compared with college or greater (adjusted odds ratio, 1.42 [95% CI, 1.12-1.79]); black (3.47 [2.97-4.05]), Hispanic (1.33 [1.10-1.61]), and other (2.46 [2.03-2.97]) maternal race or ethnicity compared with white race; household income of less than $20 000 (1.69 [1.44-1.99]) and $20 000 to $50 000 (1.29 [1.14-1.45]) compared with greater than $50 000; living in the West (1.61 [1.38-1.88]) or the South (1.47 [1.30-1.66]) compared with the Midwest; infants younger than 8 weeks (1.45 [1.21-1.73]) or ages 8 to 15 weeks (1.31 [1.17-1.45]) compared with 16 weeks or older; and being born prematurely compared with full-term (1.41 [1.22-1.62]). Almost 46% of the participants reported talking to a physician about bed sharing. Compared with those who did not receive advice from a physician, those who reported their physicians had a negative attitude were less likely to have the infant share a bed (adjusted odds ratio, 0.66 [95% CI, 0.53-0.82]), whereas a neutral attitude was associated with increased bed sharing (1.38 [1.05-1.80]).CONCLUSIONS AND RELEVANCE Our finding of a continual increase in bed sharing throughout the study period among black and Hispanic infants suggests that the current American Academy of Pediatrics recommendation about bed sharing is not universally followed. The factors associated with infant bed sharing may be useful in evaluating the impact of a broad intervention to change behavior.