Bed Sharing Among Black Infants and Sudden Infant Death Syndrome: Interactions With Other Known Risk Factors
Bed Sharing Among Black Infants and Sudden Infant Death Syndrome: Interactions With Other Known Risk Factors
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DOI：
10.1016/j.acap.2010.09.001
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发表时间：
2010-11-01
影响因子：
3.1
通讯作者：
Hauck, Fern R.
中科院分区：
文献类型：
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作者：
Fu, Linda Y.;Moon, Rachel Y.;Hauck, Fern R.
目的：同床共寝与婴儿猝死综合征（SIDS）有关，可能导致婴儿死亡率的种族差异。目前尚不清楚同床共寝如何与其他因素相互作用影响SIDS风险。我们旨在衡量同床共寝对黑人婴儿SIDS风险的影响，并确定睡眠环境的其他特征是否会改变这种风险。
方法：将195名死于SIDS的黑人婴儿的特征与匹配的对照组进行比较。使用逻辑回归分析已知的SIDS风险因素对同床共寝影响SIDS风险的调节作用。
结果：在最后一次/参考睡眠期间，近一半（47.4%）的研究人群有同床共寝行为（病例组为58%，对照组为37%）。与不同床共寝相比，同床共寝使SIDS风险增加2倍。在睡眠表面柔软、使用枕头、母亲吸烟以及婴儿年龄较小的情况下，同床共寝的有害影响更为显著。然而，即使婴儿不使用枕头或睡在坚硬的表面上，同床共寝仍然与SIDS风险增加有关。在同床共寝的婴儿中，SIDS最强的预测因素是柔软的睡眠表面、不使用安抚奶嘴以及母亲在孕期吸烟。
结论：同床共寝在黑人婴儿中是一种常见的做法。它与SIDS风险明显且强烈增加有关，当与其他已知的SIDS风险因素相结合时，风险甚至更高。这种做法可能导致黑人中SIDS发病率过高，必须制定具有文化针对性的教育方法来针对这一高危群体。
OBJECTIVE: Bed sharing has been associated with sudden infant death syndrome (SIDS) and may contribute to the racial disparity seen in infant mortality. It is unclear how bed sharing interacts with other factors to impact SIDS risk. We aimed to measure the effects of bed sharing on risk of SIDS in blacks and to determine whether the risk is modified by other characteristics of the sleep environment.METHODS: Characteristics of 195 black infants who died of SIDS were compared with matched controls. The moderating influence of known SIDS risk factors on the effect of bed sharing on risk of SIDS was examined using logistic regression.RESULTS: Almost half (47.4%) of the study population bed shared during the last/reference sleep (58% cases and 37% controls). Bed sharing was associated with 2 times greater risk of SIDS compared with not bed sharing. The deleterious effect of bed sharing was more pronounced with a soft sleep surface, pillow use, maternal smoking, and younger infant age. However, bed sharing was still associated with an increased risk of SIDS, even when the infant was not using a pillow or sleeping on a firm surface. The strongest predictors of SIDS among bed-sharing infants were soft sleep surface, nonuse of a pacifier, and maternal smoking during pregnancy.CONCLUSIONS: Bed sharing is a common practice among black infants. It is associated with a clear and strong increased risk of SIDS, which is even greater when combined with other known risk factors for SIDS. This practice likely contributes to the excess incidence of SIDS among blacks, and culturally competent education methods must be developed to target this high-risk group.