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Hazardous cosleeping environments and risk factors amenable to change: case-control study of SIDS in south west England.
BMJ. 2009 Oct 13; 339:b3666.BMJ

Abstract

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.

Authors+Show Affiliations

Department of Community Based Medicine, University of Bristol.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19826174

Citation

Blair, Peter S., et al. "Hazardous Cosleeping Environments and Risk Factors Amenable to Change: Case-control Study of SIDS in South West England." BMJ (Clinical Research Ed.), vol. 339, 2009, pp. b3666.
Blair PS, Sidebotham P, Evason-Coombe C, et al. Hazardous cosleeping environments and risk factors amenable to change: case-control study of SIDS in south west England. BMJ. 2009;339:b3666.
Blair, P. S., Sidebotham, P., Evason-Coombe, C., Edmonds, M., Heckstall-Smith, E. M., & Fleming, P. (2009). Hazardous cosleeping environments and risk factors amenable to change: case-control study of SIDS in south west England. BMJ (Clinical Research Ed.), 339, b3666. https://doi.org/10.1136/bmj.b3666
Blair PS, et al. Hazardous Cosleeping Environments and Risk Factors Amenable to Change: Case-control Study of SIDS in South West England. BMJ. 2009 Oct 13;339:b3666. PubMed PMID: 19826174.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hazardous cosleeping environments and risk factors amenable to change: case-control study of SIDS in south west England. AU - Blair,Peter S, AU - Sidebotham,Peter, AU - Evason-Coombe,Carol, AU - Edmonds,Margaret, AU - Heckstall-Smith,Ellen M A, AU - Fleming,Peter, Y1 - 2009/10/13/ PY - 2009/10/15/entrez PY - 2009/10/15/pubmed PY - 2009/10/30/medline SP - b3666 EP - b3666 JF - BMJ (Clinical research ed.) JO - BMJ VL - 339 N2 - 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. SN - 1756-1833 UR - https://www.unboundmedicine.com/medline/citation/19826174/Hazardous_cosleeping_environments_and_risk_factors_amenable_to_change:_case_control_study_of_SIDS_in_south_west_England_ L2 - http://www.bmj.com/cgi/pmidlookup?view=long&pmid=19826174 DB - PRIME DP - Unbound Medicine ER -