Small number of infants placed in supine sleeping position despite evidence of reduced SIDS risk

VANCOUVER, Canada — Only about two-thirds of term infants nationwide are placed on their backs to sleep despite evidence that it greatly reduces the risk of sudden infant death syndrome, according to data presented here at the 2014 Pediatric Academic Societies Annual Meeting.

“Although the precise cause of SIDS is still unknown, we do know that safe sleep practices, such as sleeping on the back, reduces the risk of infant death in the first year of life,” Sunah S. Hwang, MD, MPH, FAAP, a neonatologist at Boston Children’s Hospital and South Shore Hospital, said in a press release. “The Back-to-Sleep campaign reduced the rate of SIDS by 50% in the 1990s. Since 2001, this rate has remained stagnant.”

Sunah S. Hwang

Hwang and colleagues evaluated data from the Pregnancy Risk Assessment Monitoring System (PRAMS) including 392,397 infants born in 36 states to determine the rates of supine sleeping position following hospital discharge for term and preterm infants. Mothers were asked to respond by survey about which position they normally placed their infant in to sleep (supine and non-supine).

“Given that supine sleep positioning significantly reduces an infant’s risk for SIDS, it is worrisome that only two-thirds of full-term infants born in the United States are being placed back-to-sleep,” Hwang said. “More concerning is that adherence to safe sleep positioning is even lower from preterm infants who are at even greater risk for SIDS compared to term infants.”

Suboptimal rates of supine sleep positioning after hospital discharge were found among both term and preterm infants. Rates also varied widely among states with Alabama having the lowest rate (50%) and Wisconsin having the highest (81%).

The lowest rate of supine sleep positioning was found among the infants less than 28 weeks’ gestational age. Late preterm infants (34-36 weeks’ gestational age) were significantly less likely to be placed in the supine position following adjustment for maternal age, education, race/Hispanic ethnicity, marital status, previous live birth, insurance status before pregnancy, method of delivery, and maternal length of hospital stay.

“Given the concerning data about inadequate adherence to safe sleep practices for all infants, and in particular for preterm infants, we need to better engage families about adhering to safe sleep practices at the individual, community, hospital and public health levels,” Hwang said.

For more information:

Hwang S. Abstract 1690.3. Presented at: PAS 2014; May 2-6, 2014; Vancouver, Canada.

Disclosure: The researchers report no relevant financial disclosures.