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Hazardous cosleeping environments and risk factors amenable to change: case-control study of SIDS in south west England

Objectives To investigate the factors associated with sudden infant death syndrome (SIDS) from birth to age 2 years, whether recent advice has been followed, whether any new risk factors have emerged, and the specific circumstances in which SIDS occurs while cosleeping (infant sharing the same bed o...

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Autores principales: Blair, Peter S, Sidebotham, Peter, Evason-Coombe, Carol, Edmonds, Margaret, Heckstall-Smith, Ellen M A, Fleming, Peter
Formato: Texto
Lenguaje:English
Publicado: BMJ Publishing Group Ltd. 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2762037/
https://www.ncbi.nlm.nih.gov/pubmed/19826174
http://dx.doi.org/10.1136/bmj.b3666
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author Blair, Peter S
Sidebotham, Peter
Evason-Coombe, Carol
Edmonds, Margaret
Heckstall-Smith, Ellen M A
Fleming, Peter
author_facet Blair, Peter S
Sidebotham, Peter
Evason-Coombe, Carol
Edmonds, Margaret
Heckstall-Smith, Ellen M A
Fleming, Peter
author_sort Blair, Peter S
collection PubMed
description Objectives To investigate the factors associated with sudden infant death syndrome (SIDS) from birth to age 2 years, whether recent advice has been followed, whether any new risk factors have emerged, and the specific circumstances in which SIDS occurs while cosleeping (infant sharing the same bed or sofa with an adult or child). Design Four year population based case-control study. Parents were interviewed shortly after the death or after the reference sleep (within 24 hours) of the two control groups. Setting South west region of England (population 4.9 million, 184 800 births). Participants 80 SIDS infants and two control groups weighted for age and time of reference sleep: 87 randomly selected controls and 82 controls at high risk of SIDS (young, socially deprived, multiparous mothers who smoked). Results The median age at death (66 days) was more than three weeks less than in a study in the same region a decade earlier. Of the SIDS infants, 54% died while cosleeping compared with 20% among both control groups. Much of this excess may be explained by a significant multivariable interaction between cosleeping and recent parental use of alcohol or drugs (31% v 3% random controls) and the increased proportion of SIDS infants who had coslept on a sofa (17% v 1%). One fifth of SIDS infants used a pillow for the last sleep (21% v 3%) and one quarter were swaddled (24% v 6%). More mothers of SIDS infants than random control infants smoked during pregnancy (60% v 14%), whereas one quarter of the SIDS infants were preterm (26% v 5%) or were in fair or poor health for the last sleep (28% v 6%). All of these differences were significant in the multivariable analysis regardless of which control group was used for comparison. The significance of covering the infant’s head, postnatal exposure to tobacco smoke, dummy use, and sleeping in the side position has diminished although a significant proportion of SIDS infants were still found prone (29% v 10%). Conclusions Many of the SIDS infants had coslept in a hazardous environment. The major influences on risk, regardless of markers for socioeconomic deprivation, are amenable to change and specific advice needs to be given, particularly on use of alcohol or drugs before cosleeping and cosleeping on a sofa.
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spelling pubmed-27620372009-11-20 Hazardous cosleeping environments and risk factors amenable to change: case-control study of SIDS in south west England Blair, Peter S Sidebotham, Peter Evason-Coombe, Carol Edmonds, Margaret Heckstall-Smith, Ellen M A Fleming, Peter BMJ Research Objectives To investigate the factors associated with sudden infant death syndrome (SIDS) from birth to age 2 years, whether recent advice has been followed, whether any new risk factors have emerged, and the specific circumstances in which SIDS occurs while cosleeping (infant sharing the same bed or sofa with an adult or child). Design Four year population based case-control study. Parents were interviewed shortly after the death or after the reference sleep (within 24 hours) of the two control groups. Setting South west region of England (population 4.9 million, 184 800 births). Participants 80 SIDS infants and two control groups weighted for age and time of reference sleep: 87 randomly selected controls and 82 controls at high risk of SIDS (young, socially deprived, multiparous mothers who smoked). Results The median age at death (66 days) was more than three weeks less than in a study in the same region a decade earlier. Of the SIDS infants, 54% died while cosleeping compared with 20% among both control groups. Much of this excess may be explained by a significant multivariable interaction between cosleeping and recent parental use of alcohol or drugs (31% v 3% random controls) and the increased proportion of SIDS infants who had coslept on a sofa (17% v 1%). One fifth of SIDS infants used a pillow for the last sleep (21% v 3%) and one quarter were swaddled (24% v 6%). More mothers of SIDS infants than random control infants smoked during pregnancy (60% v 14%), whereas one quarter of the SIDS infants were preterm (26% v 5%) or were in fair or poor health for the last sleep (28% v 6%). All of these differences were significant in the multivariable analysis regardless of which control group was used for comparison. The significance of covering the infant’s head, postnatal exposure to tobacco smoke, dummy use, and sleeping in the side position has diminished although a significant proportion of SIDS infants were still found prone (29% v 10%). Conclusions Many of the SIDS infants had coslept in a hazardous environment. The major influences on risk, regardless of markers for socioeconomic deprivation, are amenable to change and specific advice needs to be given, particularly on use of alcohol or drugs before cosleeping and cosleeping on a sofa. BMJ Publishing Group Ltd. 2009-10-13 /pmc/articles/PMC2762037/ /pubmed/19826174 http://dx.doi.org/10.1136/bmj.b3666 Text en This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.
spellingShingle Research
Blair, Peter S
Sidebotham, Peter
Evason-Coombe, Carol
Edmonds, Margaret
Heckstall-Smith, Ellen M A
Fleming, Peter
Hazardous cosleeping environments and risk factors amenable to change: case-control study of SIDS in south west England
title Hazardous cosleeping environments and risk factors amenable to change: case-control study of SIDS in south west England
title_full Hazardous cosleeping environments and risk factors amenable to change: case-control study of SIDS in south west England
title_fullStr Hazardous cosleeping environments and risk factors amenable to change: case-control study of SIDS in south west England
title_full_unstemmed Hazardous cosleeping environments and risk factors amenable to change: case-control study of SIDS in south west England
title_short Hazardous cosleeping environments and risk factors amenable to change: case-control study of SIDS in south west England
title_sort hazardous cosleeping environments and risk factors amenable to change: case-control study of sids in south west england
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2762037/
https://www.ncbi.nlm.nih.gov/pubmed/19826174
http://dx.doi.org/10.1136/bmj.b3666
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