Using surveillance data to inform a SUID reduction strategy in Massachusetts

Area of Science:

• Public Health
• Maternal and Child Health
• Epidemiology

Background:

• Non-supine infant sleep positions increase the risk of sudden unexpected infant death (SUID).
• Disparities in safe sleep practices are linked to socioeconomic factors like maternal income and race/ethnicity.
• The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) serves low-income pregnant and postpartum women.

Purpose of the Study:

• To investigate the association between WIC status and infant safe sleep practices in Massachusetts.
• To inform the development of a SUID intervention strategy.
• To analyze data from the Pregnancy Risk Assessment Monitoring System (PRAMS) survey.

Main Methods:

• Utilized data from the Massachusetts Pregnancy Risk Assessment Monitoring System (PRAMS) survey (2007-2010).
• Calculated Risk Ratios (RR) and 95% confidence intervals (CI) for infant supine sleep positioning based on WIC enrollment.
• Analyzed data from a weighted sample of 276,252 postpartum women.

Main Results:

• WIC-enrolled mothers were less likely to consistently place infants in supine sleeping positions compared to non-WIC mothers (RR=0.81).
• Significant differences in infant sleep positioning by WIC status were observed annually and in aggregate.
• The mean survey response rate was 69%.

Conclusions:

• Massachusetts WIC mothers demonstrated higher rates of non-supine infant sleep positions compared to non-WIC mothers.
• This association highlights the potential for WIC-based safe sleep interventions to reduce SUID.
• WIC's infrastructure makes it a viable platform for a national SUID reduction strategy.