Risk factor changes for sudden infant death syndrome after initiation of Back-to-Sleep campaign
Felicia L Trachtenberg1, Elisabeth A Haas, Hannah C Kinney
1New England Research Institutes, Watertown, Massachusetts, USA.
Pediatrics
|March 28, 2012
Summary
The Back-to-Sleep campaign reduced prone sleeping but increased bed-sharing for sudden infant death syndrome (SIDS) cases. Despite changes in risk factors, multiple risks remain common, highlighting the need for comprehensive prevention strategies.
Area of Science:
- Pediatrics
- Public Health
- Epidemiology
Background:
- Sudden Infant Death Syndrome (SIDS) remains a significant concern in infant mortality.
- The Back-to-Sleep (BTS) campaign aimed to reduce SIDS by promoting safer sleep practices.
- Understanding the evolving risk factor profile post-BTS is crucial for targeted prevention.
Purpose of the Study:
- To evaluate changes in SIDS risk factors following the initiation of the Back-to-Sleep campaign.
- To document the prevalence and patterns of multiple risk factors in SIDS cases.
- To determine the age-specific profile of SIDS risk factors.
Main Methods:
- Analysis of 568 SIDS cases from the San Diego SIDS/Sudden Unexplained Death in Childhood Research Project (1991-2008).
- Utilized standardized death scene investigations and autopsies to identify intrinsic (e.g., male gender) and extrinsic (e.g., prone sleep) risk factors.
- Compared risk factor prevalence before (1991-1993) and after (1996-2008) the BTS campaign.
Main Results:
- A significant decrease in prone sleeping (84.0% to 48.5%) and upper respiratory tract infection symptoms (46.6% to 24.8%) was observed.
- Bed-sharing increased significantly (19.2% to 37.9%), particularly in infants under 2 months (29.0% vs 63.8%).
- The prevalence of prematurity increased (20.0% to 29.0%), while the average number of risks per SIDS infant remained unchanged.
Conclusions:
- SIDS cases in the BTS era exhibit greater risk factor variation.
- A high prevalence of both intrinsic and extrinsic risk factors persists, both pre- and post-BTS campaign.
- Comprehensive SIDS risk reduction campaigns focusing on multiple and simultaneous risks are essential for prevention, especially for vulnerable infants.
