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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Changes in sleep position during infancy: a prospective longitudinal assessment
S M Lesko1, M J Corwin, R M Vezina
1Slone Epidemiology Unit, Boston University School of Medicine, Brookline, Mass 02146, USA. leskos@bu.edu
Insights
Many infants switch to prone sleeping positions between 1 and 3 months of age. Risk factors include maternal race/ethnicity, younger maternal age, higher parity, and male infant sex, increasing sudden infant death syndrome (SIDS) risk.
Area of Science:
- Pediatrics
- Public Health
- Epidemiology
Background:
- Prone sleeping in infants is a known risk factor for sudden infant death syndrome (SIDS).
- Understanding the prevalence and risk factors for prone sleeping is crucial for SIDS prevention strategies.
Purpose of the Study:
- To determine the prevalence of infant prone sleeping during the first six months of life.
- To identify maternal and infant characteristics associated with prone sleeping.
Main Methods:
- Prospective cohort study of 7796 mothers and their infants in Eastern Massachusetts and northwest Ohio.
- Data collected on maternal and infant characteristics related to prone sleeping at 1 and 3 months of age.
- Statistical analysis using odds ratios (OR) and 95% confidence intervals (CI) to identify risk factors.
Main Results:
- Prone sleeping increased from 18% at 1 month to 29% at 3 months.
- At 1 month, prone sleeping was associated with non-Hispanic black or Hispanic race/ethnicity, younger maternal age, less education, and higher parity.
- At 3 months, prone sleeping was associated with non-Hispanic black or Hispanic race/ethnicity, younger maternal age, higher parity, and male infant sex.
Conclusions:
- A significant proportion of infants transition to prone sleeping between 1 and 3 months of age.
- These findings highlight the need for continued education on safe infant sleep practices.
- If these trends are national, many US infants are at increased risk for SIDS due to prone sleeping.
Context:
Prone sleeping by infants has been associated with an increased risk of sudden infant death syndrome.
Objective:
To document the prevalence of and identify risk factors for prone sleeping during the first 6 months of life.
Design:
Prospective cohort study.
Setting:
Eastern Massachusetts and northwest Ohio.
Study Participants:
A total of 7796 mothers of infants weighing 2500 g or more at birth.
Main Outcome Measures:
Maternal and infant characteristics related to prone sleeping at 1 month and 3 months of age.
Results:
Between 1 month and 3 months of age, prone sleeping increased from 18% to 29%. At 1 month, prone sleeping was associated with the following maternal characteristics: non-Hispanic black or Hispanic race/ethnicity, younger age, less education, and higher parity. At 3 months, switching from nonprone to prone position was associated with mother's race/ethnicity of non-Hispanic black (odds ratio [OR], 1.7; 95% confidence interval [CI], 1.2-2.3) or Hispanic (OR, 1.5; 95% CI, 1.1-2.2); younger maternal age (compared with mothers >34 years: 18-24 years, OR, 1.6; 95% CI, 1.2-2.2; <18 years, OR, 2.2; 95% CI, 1.2-4.3); increasing parity (compared with 1 child: 2 children, OR, 1.5; 95% CI, 1.2-1.8; > or =3 children, OR, 1.7; 95% CI, 1.4-2.2); and infant sex (male sex, OR, 1.4; 95% CI, 1.2-1.7).
Conclusions:
If infant sleeping practices in the study communities are representative of practices throughout the United States, a substantial number of infants who slept nonprone at 1 month sleep prone at 3 months.
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