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International Child Care Practices Study: infant sleep position and parental smoking
1Department of Paediatrics, The Chinese University of Hong Kong, 6/F Clinical Science Building, Prince of Wales Hospital, Shatin, Hong Kong, China. tony-nelson@cuhk.edu.hk
Insights
This study analyzed sudden infant death syndrome (SIDS) risk factors, infant sleep position, and parental smoking across 17 countries. Results show significant global variations in sleep practices and smoking prevalence, highlighting potential for intervention.
Area of Science:
- Pediatrics
- Public Health
- Epidemiology
Background:
- Sudden Infant Death Syndrome (SIDS) remains a significant concern in infant mortality.
- Key modifiable risk factors include infant sleep position and parental smoking.
- Understanding global variations in these factors is crucial for targeted prevention strategies.
Purpose of the Study:
- To present descriptive data on infant sleep position and parental smoking from the International Child Care Practices Study (ICCPS).
- To analyze variations in these SIDS risk factors across 21 centers in 17 countries.
- To explore potential patterns and implications for SIDS risk reduction.
Main Methods:
- The ICCPS surveyed parents of infants at birth (interview) and 3 months (postal questionnaire) using a standardized protocol.
- Data were collected from 5488 families, with 4656 (85%) completing follow-up questionnaires.
- Descriptive analysis was performed using Epi Info, with centers grouped by geographic location and SIDS awareness levels.
Main Results:
- Overall, 52.5% of infants were placed supine (back), 37.8% side, and 13% prone (front).
- Supine sleeping prevalence varied widely, from 14% in Santiago, Chile, to 89% in Tokyo/Yokohama, Japan.
- Maternal smoking rates ranged from 0% to 34%, and paternal rates from 10% to 64%, with distinct patterns between Western and other countries.
Conclusions:
- Significant international variations exist in infant sleep position and parental smoking rates, both key SIDS risk factors.
- Observed smoking prevalence differences may reflect stages of the smoking epidemic and suggest potential for reduction.
- These findings underscore the importance of culturally sensitive SIDS risk reduction campaigns.
Unlabelled:
The International Child Care Practices Study (ICCPS) collected descriptive data from 21 centres in 17 countries. In this report, data are presented on the key sudden infant death syndrome (SIDS) risk factors of infant sleep position and parental smoking.
Methods:
Using a standardised protocol, parents of infants were surveyed at birth by interview, and at 3 months of age mainly by postal questionnaire. Data entry and descriptive analysis were undertaken with Epi Info. Centres were grouped according to geographic location. Also indicated was the level of SIDS awareness in the community, i.e. whether any campaigns or messages to "reduce the risks of SIDS" were available at the time of the survey.
Results:
Birth interview data were available for 5488 individual families, and 4656 (85%) returned questionnaires at 3 months. Overall, 52.5% (95% CI, 43.5-61.3) of infants were placed in the supine or back sleep position, 37.8% (95% CI, 30.6-45.7) in the side position and 13% (95% CI, 9.3-17.9) in the prone or front position. The prevalence of supine sleeping ranged from 14% (Santiago, Chile) to 89% (Tokyo/Yokohama, Japan). The prevalence of reported smoking was between 0% and 34% for mothers and 10% and 64% for fathers. In samples from Western countries, there was a trend for rates of maternal smoking to be similar to paternal smoking, whereas in other samples, low rates of maternal smoking contrasted with high rates of paternal smoking.
Conclusions:
These data highlight considerable variations and interesting patterns in the prevalence of these two important SIDS risk factors in these diverse samples. Impressive differences in rates of smoking within and between these communities may reflect different stages of the inevitable progression of the smoking epidemic, but may also provide some encouragement that reduction in smoking rates, in both mothers and fathers, is possible.