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Trends and predictors of infant sleep positions in Georgia, 1990 to 1995
M Saraiya1, F Serbanescu, R Rochat
1Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA 30341, USA.
Insights
The prone sleeping position for infants significantly decreased from 49% in 1990 to 15% in 1995, coinciding with national risk-reduction campaigns. Targeted interventions are needed for groups with higher prone sleeping prevalence to achieve national safe sleep goals.
Area of Science:
- Pediatrics
- Public Health
- Epidemiology
Background:
- Sudden infant death syndrome (SIDS) is a leading cause of infant mortality.
- The prone sleeping position is the strongest modifiable risk factor for SIDS.
- National campaigns promote nonprone sleeping positions (back or side) for infants.
Purpose of the Study:
- To evaluate trends in the prevalence of infant prone sleeping position from 1990 to 1995.
- To identify predictors of prone sleeping position among mothers.
- To assess the impact of national risk-reduction strategies.
Main Methods:
- Utilized data from the Georgia Women's Health Survey (N=3130).
- Analyzed infant sleep position for the first 2 months of life (N=868).
- Employed multiple logistic regression to determine predictors of prone sleeping (n=636).
Main Results:
- Prone sleeping prevalence decreased significantly from 49% (1990) to 15% (1995).
- The shift was primarily to the side position, not the back.
- Higher odds of prone sleeping were associated with late prenatal care, Black mothers, lower education, rural residence, and mothers with previous children.
Conclusions:
- Significant decrease in infant prone sleeping position observed, aligning with national safe sleep promotion efforts.
- Targeted interventions are crucial for specific demographic groups to further reduce prone sleeping.
- Emphasis on back sleeping is recommended to achieve national SIDS risk-reduction goals.
Background:
In recent years, the prone sleeping position has emerged as the strongest modifiable risk factor for sudden infant death syndrome, the leading cause of infant mortality between 1 month and 1 year of age in the United States. Since April 1992, sudden infant death syndrome risk-reduction strategies have included the promotion of the back or side sleeping position (nonprone) for healthy infants younger than 1 year of age. Most recently, the back position has been advocated as the best sleeping position and the side position as an alternative.
Methods:
To evaluate trends in prevalence of the prone position from 1990 to 1995, we used data available from the Georgia Women's Health Survey, a random digit-dialed telephone survey of 3130 women 15 to 44 years of age. We examined the position in which women put their infant to sleep in the first 2 months of life for their most recent live birth (N = 868) and determined independent predictors of prone sleep position among women who consistently used the prone or the back/side position (n = 636) using multiple logistic regression.
Results:
The prevalence of mothers who put their infant to sleep in the prone position significantly decreased, from 49% in 1990 to 15% in 1995. This decrease is primarily attributable to a major shift to the side position rather than to the back. Using multiple logistic regression, we found the prone sleeping position to be significantly higher among women who entered prenatal care after the first trimester (odds ratio [OR], 3.6; 95% confidence interval [CI], 1.4-9.2), were black (OR, 2.1; 95% CI, 1.4-3.1), had less than a high school education (OR, 2.2; 95% CI, 1.4-3.4), and were living in rural Georgia (OR, 1.9; 95% CI, 1.3-2.7). For the period after April 1992, women who had previous children were 2.6 (OR, 95% CI, 1.7-4.1) times more likely to use the prone sleep position than were first-time mothers.
Conclusions:
The prevalence of the use of the prone sleep position for infants decreased significantly over the study period. This decrease coincided with national efforts to promote the back or side sleeping position. Increased efforts should target groups who are more likely to use the prone position to attain the national goal of