Non-back sleeping, soft bedding associated with infant suffocation
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Non-back sleeping and soft bedding were among the factors associated with infant sleep deaths, according to a study published in Pediatrics.
Co-author Sharyn E. Parks Brown, MD, MPH, an epidemiologist in the CDC’s Division of Reproductive Health, told Healio that “approximately 3,400 infants die suddenly and unexpectedly in the U.S. each year.”
“The most common causes are from sudden unexpected infant deaths [SUID], which includes sudden infant death syndrome [SIDS], accidental suffocation or strangulation in a sleeping environment, and other deaths from unknown causes,” Parks Brown said. “Case-control studies of unsafe sleep environments are a basis for SUID reduction campaigns, including the Safe to Sleep Campaign in the United States.”
She said the understanding of sleep‐related suffocation risk was “limited by the lack of information about the sleep environment in some previous analyses of vital records data and by limited use of comparison groups in other studies.”
“Very few case‐control studies of SUID have been published in the last 20 years,” Parks Brown said. “Addressing these limitations is critical to improve our understanding and inform prevention strategies.”
Parks Brown and colleagues retrieved data for their control group of liveborn infants from the CDC’s Pregnancy Risk Assessment Monitoring System and data on SIDS deaths from the CDC’s Sudden Unexpected Infant Death Case Registry. They ran two case-control studies dividing sudden infant deaths into two groups: unexplained, including but not limited to SIDS; and sleep suffocation deaths.
The risk factors they examined included infant sleep practices that have been identified as factors associated with SIDS, such as sleep position, soft bedding, sleep surface type, sleep surface sharing, and room sharing.
The study included 112 sleep-related suffocation cases with 448 age-matched controls, and 300 unexplained infant deaths cases with 1,200 age-matched controls.
“We were able to confirm previous findings from SIDS literature, but we were also able to report some new findings that can help us to really focus our messages to save infant lives,” Parks Brown said.
The researchers confirmed that there is an increased risk for sudden unexplained infant death associated with nonsupine sleep, soft bedding use and surface sharing.
“We were able to independently estimate risk factors for sleep‐related suffocation deaths,” Parks Brown said. “Significance of associations between sleep environment‐related risk factors and sleep‐related suffocation followed similar patterns as those for unexplained infant death.”
Still, Parks Brown said, the magnitude of risk associated with sleep environment factors were generally larger for suffocation, with the use of soft bedding associated with a 16 times greater risk for suffocation. Soft bedding was also associated with a five times greater risk for sudden unexplained infant death.
“These new findings are promising because suffocation is something for which the concept of prevention has been found to be more easily understood by parents,” Parks Brown said. “With this new information, we will be better able to communicate with parents regarding preventing infant sleep‐related deaths.”