Abstract
OBJECTIVE--To examine the impact of changing practice with regard to infant sleeping position on mortality from the sudden infant death syndrome. DESIGN--A population based study of all infants dying suddenly and unexpectedly during February 1990 to July 1991, and two groups of controls; one comprising every 125th baby born to Avon residents and the other comprising pairs of infants matched to each index case for age, neighbourhood, and date of study. Information about sleeping position was collected at home visits soon after the index baby's death or, for the population based controls, on several occasions in the first six months of life. The design was comparable to that of an earlier study of the same population. SETTING--County of Avon. SUBJECTS--35 infants who died suddenly and unexpectedly (32 of the sudden infant death syndrome), 70 matched controls, and 152 population based controls. RESULTS--The prevalence of prone sleeping in the matched controls was much lower than that found in an earlier study in Avon (28% (18/64) 1990-1 v 58% (76/131) 1987-9; p less than 0.001) and was comparable with the prevalence in population based controls (29%). This would be expected to lead to a reduction in the incidence of the sudden infant death syndrome to 2.0/1000 live births (95% confidence interval 1.8/1000 to 2.5/1000). The actual mortality fell from 3.5/1000 in 1987-9 to 1.7/1000. CONCLUSION--The fall in mortality can be almost entirely accounted for by the reduction in prone sleeping, suggesting a causal relation exists between them. Side and supine positions confer protection but the side position is unstable and the infant may roll prone. We therefore recommend supine as the safest sleeping position for babies.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Beal S. Sleeping position and sudden infant death syndrome. Med J Aust. 1988 Nov 21;149(10):562–562. [PubMed] [Google Scholar]
- Dwyer T., Ponsonby A. L., Newman N. M., Gibbons L. E. Prospective cohort study of prone sleeping position and sudden infant death syndrome. Lancet. 1991 May 25;337(8752):1244–1247. doi: 10.1016/0140-6736(91)92917-q. [DOI] [PubMed] [Google Scholar]
- Fleming P. J., Gilbert R., Azaz Y., Berry P. J., Rudd P. T., Stewart A., Hall E. Interaction between bedding and sleeping position in the sudden infant death syndrome: a population based case-control study. BMJ. 1990 Jul 14;301(6743):85–89. doi: 10.1136/bmj.301.6743.85. [DOI] [PMC free article] [PubMed] [Google Scholar]
- de Jonge G. A., Engelberts A. C. Cot deaths and sleeping position. Lancet. 1989 Nov 11;2(8672):1149–1150. doi: 10.1016/s0140-6736(89)91504-3. [DOI] [PubMed] [Google Scholar]