Changing parental high risk behaviour in the reduction of SIDS: the imperative of translational research

Hepworth, Julie and Bogossian, Fiona E. (2009) Changing parental high risk behaviour in the reduction of SIDS: the imperative of translational research. BMJ, : 1-11.

Author Hepworth, Julie
Bogossian, Fiona E.
Title Changing parental high risk behaviour in the reduction of SIDS: the imperative of translational research
Journal name BMJ
ISSN 1756-1833
0959-535X
Publication date 2009-10-19
Year available 2009
Sub-type Article (original research)
Start page 1
End page 11
Total pages 11
Editor David Payne
Fiona Godlee
Place of publication London, United Kingdom
Publisher BMJ Group
Language eng
Formatted 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.
Keyword SIDS
Parental risk behaviour
Infant mortality
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ
Additional Notes Published online: Rapid response

Document type: Journal Article
Sub-type: Article (original research)
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Created: Fri, 18 Dec 2009, 13:21:28 EST by Vicki Percival on behalf of School of Nursing and Midwifery