Environment of infants during sleep and risk of the sudden infant death syndrome: Results of 1993-5 case-control study for confidential inquiry into stillbirths and deaths in infancy
Environment of infants during sleep and risk of the sudden infant death syndrome: Results of 1993-5 case-control study for confidential inquiry into stillbirths and deaths in infancy
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DOI：
10.1136/bmj.313.7051.191
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发表时间：
1996-07-27
影响因子：
105.7
通讯作者：
McCabe, R
中科院分区：
文献类型：
--
作者：
Fleming, PJ;Blair, PS;McCabe, R
目的探讨全国性降低婴儿猝死综合征风险运动后睡眠安排作为婴儿猝死综合征危险因素的作用。设计-两年基于人群的病例对照研究。对每个死亡婴儿和四个年龄和日期匹配的对照组进行父母访谈。设置-英格兰三个地区，总人口1700万人。受试者-195名死亡婴儿和780名匹配的对照组。结果-调整母亲年龄，产次，妊娠，出生体重，暴露于烟雾和睡眠环境中的其他相关因素（多变量比值比分别为9.00（95%置信区间2.84至28.47）和1.84（1.02至3.31））。侧睡而非俯卧的发生率较高，导致较高的人群归因风险（侧睡18.4%，俯卧14.2%）。更多的死亡婴儿被发现时头上有床罩（21.58; 6.21至74.99）。使用假人具有明显的保护作用（0.38; 0.21至0.70）。对于母亲吸烟的婴儿来说，整夜同床是一个显著的危险因素（9.25; 2.31至34.02）。没有保护作用的母乳喂养可以确定多变量analysis. Conclusions，这项研究证实了婴儿猝死综合征的某些危险因素的重要性，并确定其他人，例如，涵盖了头部，侧睡的位置，这可能是经得起改变教育和告知父母和卫生保健专业人员。
Objective-To investigate the role of sleeping arrangements as risk factors for the sudden infant death syndrome after a national risk reduction campaign.Design-Two year population based case-control study. Parental interviews were conducted for each infant who died and for four controls matched for age and date of interview.Setting-Three regions in England with a total population of 17 million people.Subjects-195 babies who died and 780 matched controls.Results-Prone and side sleeping positions both carried increased risks of death compared with supine when adjusted for maternal age, parity, gestation, birth weight, exposure to smoke, and other relevant factors in the sleeping environment (multivariate odds ratio = 9.00 (95% confidence interval 2.84 to 28.47) and 1.84 (1.02 to 3.31), respectively). The higher incidence of side rather than prone sleeping led to a higher population attributable risk (side 18.4%, prone 14.2%). More of the infants who died were found with bed covers over their heads (21.58; 6.21 to 74.99). The use of a dummy had an apparent protective effect (0.38; 0.21 to 0.70). Bed sharing for the whole night was a significant risk factor for infants whose mothers smoked (9.25; 2.31 to 34.02). No protective effect of breast feeding could be identified on multivariate analysis.Conclusions-This study confirms the importance of certain risk factors for the sudden infant death syndrome and identifies others-for example, covers over the head, side sleeping position-which may be amenable to change by educating and informing parents and health care professionals.