Prone sleeping position and SIDS: evidence from recent case-control and cohort studies in Tasmania

The most recent data from the cohort and case-control studies of SIDS and prone position recently reported from Tasmania are reviewed. The cohort analysis was based on 4103 infants born between 1 January 1988 and 1 December 1990 assessed as being at high risk at birth, of whom 29 later died of SIDS. A matched analysis which controlled for infant birthweight and maternal age indicated that prone sleeping position was associated with an increased risk of SIDS (OR 3.92, 95% Cl [1.37-11.24]). The case-control study was based on all (n = 55) Tasmanian SIDS death from October 1989 to April 1991 and matched live controls. The unadjusted odds ratio for prone position and SIDS was 5.04 (95% Cl [2.29-11.11]). The population attributable risk percentage, based on the high risk cohort data, was 0.38 (95% Cl [0.35-0.41]), suggesting that a significant reduction in SIDS incidence might occur if the prevalence of the prone sleeping position in the infant population were reduced. Other factors which may be important for the development of any public health interventions to reduce SIDS based on these findings are discussed.