Bed Sharing and the Risk of Sudden Infant Death Syndrome: Can We Resolve the Debate?

Institute of Legal Medicine, University of Münster, Münster, Germany.
The Journal of pediatrics (Impact Factor: 3.79). 08/2011; 160(1):44-8.e2. DOI: 10.1016/j.jpeds.2011.06.052
Source: PubMed


To conduct a meta-analysis on the relationship between bed sharing and sudden infant death syndrome (SIDS) risk.
Data from PubMed and Medline were searched for studies published after Jan 1, 1970. The search strategy included articles with the terms "sudden infant death syndrome," "sudden unexpected death," and "cot death" with "bed sharing" or "co-sleeping." To further specify the potential risk of bed sharing and SIDS, subgroup analyses were performed.
Eleven studies met inclusion criteria and were included in the final meta-analysis. The combined OR for SIDS in all bed sharing versus non-bed sharing infants was 2.89 (95% CI, 1.99-4.18). The risk was highest for infants of smoking mothers (OR, 6.27; 95% CI, 3.94-9.99), and infants <12 weeks old (OR, 10.37; 95% CI, 4.44-24.21).
Bed sharing is a risk factor for SIDS and is especially enhanced in smoking parents and in very young infants.

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    • "ding vari - ables , such as age and sex , occurs during the design phase of a study ( Elwood , 2007 ; Pearce & Green - land , 2014 ) . Maternal age , education level , ethnic - ity , socioeconomic status , and type of infant feeding are now known to be confounders in the bed sharing and SIDS relationship ( Carpenter et al . , 2013 ; Hogan , 2014 ; Vennemann et al . , 2012 ) . It is therefore reasonable to match participants based on these variables ; however , matching for more than two or three variables can make it challenging to find appropriate controls ( Pearce & Greenland , 2014 ) . Thus , matching in the bed sharing and SIDS research is often limited to matching by age and geographic region ( see "
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    ABSTRACT: Confounding is an important concept for public health nurses (PHNs) to understand when considering the results of epidemiological research. The term confounding is derived from Latin, confundere, which means to "mix-up" or "mix together". Epidemiologists attempt to derive a cause and effect relationship between two variables traditionally known as the exposure and disease (e.g., smoking and lung cancer). Confounding occurs when a third factor, known as a confounder, leads to an over- or underestimate of the magnitude of the association between the exposure and disease. An understanding of confounding will facilitate critical appraisal of epidemiological research findings. This knowledge will enable PHNs to strengthen their evidence-based practice and better prepare them for policy development and implementation. In recent years, researchers and clinicians have examined the relationship between bed sharing and sudden infant death syndrome (SIDS). The discussion regarding the risk of bed sharing and SIDS provides ample opportunity to discuss the various aspects of confounding. The purpose of this article is to use the bed sharing and SIDS literature to assist PHNs to understand confounding and to apply this knowledge when appraising epidemiological research. In addition, strategies that are used to control confounding are discussed. © 2015 Wiley Periodicals, Inc.
    Full-text · Article · May 2015 · Public Health Nursing
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    • "In their conclusions Vennemann et al acknowledge there is emerging evidence of a significant interaction between bed sharing and parental use of alcohol and drugs as well as an excess of SIDS bed sharing deaths on sofas that their meta-analysis could not examine [12]. Carpenter and colleagues reflected many of the same findings [17] when pooling data from a portion of these case control studies. "
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    ABSTRACT: For much of human history infant survival has been largely predicated by close and continuous contact between the infant and the primary carer–almost always the mother.Many factors in post-industrial human society - notably tobacco smoking, alcohol intake and the use of recreational drugs–have been associated with increased risk to infants sleeping in close proximity to their mothers. This is particularly true for mothers who choose not to breastfeed.The question of the risks and possible benefits of bed-sharing for mothers who plan to breastfeed, do not smoke, do not drink alcohol or take recreational drugs, and are aware of how to ensure a safe infant sleep environment need to be quantified.In this paper we review the evidence from several epidemiological studies and identify the factors that make bedsharing more or less hazardous for the infant. This analysis is important in allowing us to give parents accurate and unbiased information on which to make their own choices about optimal night time care of their infants without demonising normal parental behaviour or practices.
    Full-text · Article · Nov 2014 · Paediatric respiratory reviews
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    • "A recently done meta-analysis on relationship between bed sharing and SIDS included case-control studies with predefined criteria (an adequate definition for SIDS; autopsies performed in >95% of cases; an appropriate description of SIDS ascertainment in the study population; a clear description of the process of control selection; and sufficient data to calculate ORs and 95% CIs or the actual ORs and 95% CIs were provided) [34]. The combined OR for SIDS in all bed share versus nonbed share infants was 2.89 (95% CI 1.99, 4.18). "
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    ABSTRACT: Background. There is conflicting evidence regarding the safety and efficacy of bed sharing during infancy-while it has been shown to facilitate breastfeeding and provide protection against hypothermia, it has been identified as a risk factor for SIDS. Methods. A systematic search of major databases was conducted. Eligible studies were observational studies that enrolled infants in the first 4 weeks of life and followed them up for a variable period of time thereafter. Results. A total of 21 studies were included. Though the quality of evidence was low, bed sharing was found to be associated with higher breastfeeding rates at 4 weeks of age (75.5% versus 50%, OR 3.09 (95% CI 2.67 to 3.58), P = 0.043) and an increased risk of SIDS (23.3% versus 11.2%, OR 2.36 (95% CI 1.97 to 2.83), P = 0.025). Majority of the studies were from developed countries, and the effect was almost consistent across the studies. Conclusion. There is low quality evidence that bed sharing is associated with higher breast feeding rates at 4 weeks of age and an increased risk of SIDS. We need more studies that look at bed sharing, breast feeding, and hazardous circumstance that put babies at risk.
    Full-text · Article · Jan 2014 · International Journal of Pediatrics
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