Risk factors for the infant prone sleep position
J. A. Taylor and R. L. Davis
Department of Pediatrics, University of Washington School of Medicine, Seattle, USA.
OBJECTIVE: To identify parental characteristics associated with infants
being placed to sleep in the prone position. STUDY DESIGN: Cross-sectional
survey. PATIENTS: Randomly selected King County, Washington, infants born
on the same days as King County infants who died of sudden infant death
syndrome between November 1992 and October 1994. METHODS: Parents of study
infants responded to a telephone interview about sleep position in their
infants. Parents were asked how they usually put their infants to bed
during the previous 2 weeks, and if they were aware of any recent advice on
sleep position in young infants. Demographic data were also collected
during the telephone interview. Logistic regression was used to identify
infant and parental characteristics associated with the prone sleep
position. RESULTS: Parents of 178 infants were interviewed; 28.1% responded
that their infants usually slept prone, 66.9% slept nonprone, and 5% had no
usual sleep position. Parents who were unaware of sleep position advice
were more likely to place their infants prone than those who were aware of
this advice (odds ratio, 3.5; 95% confidence interval, 1.5-7.8). Among
parents who were aware of sleep position advice, mothers younger than 20
years were more than 10 times as likely to place their infants prone than
were older mothers (odds ratio, 10.7; 95% confidence interval, 1.1-107.0).
For those who were unaware of sleep position advice, single mothers were
more likely to place their infants prone (odds ratio, 14.0; 95% confidence
interval, 1.5-133.2). Single mothers and parents of low-birth-weight
infants were more likely to be unaware of recent medical advice regarding
optimal sleep position for infants. CONCLUSIONS: The results of this study
may provide direction to future efforts to encourage nonprone sleeping.
Knowledge of the risk is associated with decreased use of prone sleep
position. Single mothers should be targeted for intensive educational
efforts regarding the hazards of prone sleeping. Among teenage mothers,
awareness of the association between prone sleeping and sudden infant death
syndrome may not be adequate to change behavior; educational interventions
that are more focused for this age group may be needed.
