The contribution of changes in the prevalence of prone sleeping position to the decline in sudden infant death syndrome in Tasmania.
ABSTRACT To determine the independent contribution of changes in infant sleep position to the recent decline in sudden infant death syndrome (SIDS) rate in Tasmania.
(1) A comparison of the whole population incidence of SIDS before and after an intervention to reduce the prevalence of prone sleeping position. (2) A within-cohort analysis of the contribution of sleep position and other exposures to the decline in SIDS after the intervention.
(1) All SIDS cases from 1975 through 1992. (2) A sample of one in five infants born in Tasmania who at perinatal assessment were scored to be at higher risk for SIDS since January 1988. Of 5534 infants included in the study, 39 later died of SIDS.
Multiple public health activities to reduce the prevalence of the prone infant sleeping position in Tasmania and verbal information on the association between prone position and SIDS to cohort participants from May 1, 1991.
Sudden infant death syndrome incidence.
The Tasmanian SIDS rate decreased (P < .01) from 3.8 (95% confidence interval [CI], 3.5 to 4.2) deaths per 1000 live births from 1975 through 1990 to a rate of 1.5 (95% CI, 0.9 to 2.2) deaths per 1000 live births in 1991 through 1992. The SIDS mortality rate in the cohort by period of birth was 7.6 (95% CI, 4.9 to 10.3) deaths per 1000 live births for those born from May 1, 1988, through April 30, 1991, and 4.1 (95% CI, 1.3 to 7.0) deaths per 1000 infants for those born from May 1, 1991, through October 31, 1992. The prevalence of usual prone sleeping position at 1 month of age was 29.9% and 4.3% in these two cohorts, respectively (adjusted odds ratio, 0.11; 95% CI, 0.08 to 0.13). Logistic regression demonstrated that 70% of the SIDS rate reduction in the cohort could be accounted for by the decreased prevalence of the prone sleeping position. Other factors examined individually contributed to less than 10% of the SIDS rate reduction.
The major contributing factor to the recent SIDS rate decline in Tasmania has been the reduction in the proportion of infants usually sleeping prone.
SourceAvailable from: Tomasina Stacey[Show abstract] [Hide abstract]
ABSTRACT: The United Kingdom has one of the highest rates of stillbirth in Europe, resulting in approximately 4,000 stillbirths every year. Potentially modifiable risk factors for late stillbirths are maternal age, obesity and smoking, but the population attributable risk associated with these risk factors is small.Recently the Auckland Stillbirth Study reported that maternal sleep position was associated with late stillbirth. Women who did not sleep on their left side on the night before the death of the baby had double the risk compared with sleeping on other positions. The population attributable risk was 37%. This novel observation needs to be replicated or refuted.Methods/design: Case control study of late singleton stillbirths without congenital abnormality. Controls are women with an ongoing singleton pregnancy, who are randomly selected from participating maternity units booking list of pregnant women, they are allocated a gestation for interview based on the distribution of gestations of stillbirths from the previous 4 years for the unit. The number of controls selected is proportional to the number of stillbirths that occurred at the hospital over the previous 4 years.Data collection: Interviewer administered questionnaire and data extracted from medical records. Sample size: 415 cases and 830 controls. This takes into account a 30% non-participation rate, and will detect an OR of 1.5 with a significance level of 0.05 and power of 80% for variables with a prevalence of 57%, such as non-left sleeping position.Statistical analysis: Mantel-Haenszel odds ratios and unconditional logistic regression to adjust for potential confounders.BMC Pregnancy and Childbirth 05/2014; 14(1):171. DOI:10.1186/1471-2393-14-171 · 2.15 Impact Factor
Australian Journal of Psychology 03/2011; 63(1). DOI:10.1111/j.1742-9536.2011.00025.x · 1.08 Impact Factor
Archives de Pédiatrie 11/2001; 8(11). DOI:10.1016/S0929-693X(01)00647-9 · 0.41 Impact Factor