Safe sleep practices in a New Zealand community and development of a Sudden Unexpected Death in Infancy (SUDI) risk assessment instrument

BMC Pediatrics

Barry J Taylor⁴  Rachael Taylor³  Julie Lawrence⁴  Anne-Louise M Heath¹  Rachel M Sayers⁴  Andrew Gray²  Barbara C Galland⁴ 

[1] Department of Human Nutrition, University of Otago, Dunedin, New Zealand;Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand;Department of Medicine, University of Otago, Dunedin, New Zealand;Department of Women’s & Children’s Health, University of Otago, Dunedin, New Zealand

关键词: Parental smoking;    SIDS;    Prone sleeping;    Maternal depression;    Environmental risk factors;    Breastfeeding;    Bed sharing;   

Others  :  1121189
DOI  :  10.1186/1471-2431-14-263

 received in 2014-04-17, accepted in 2014-10-03,  发布年份 2014

【 摘 要 】

Background

Interventions to prevent sudden unexpected death in infancy (SUDI) have generally been population wide interventions instituted after case–control studies identified specific childcare practices associated with sudden death. While successful overall, in New Zealand (NZ), the rates are still relatively high by international comparison. This study aims to describe childcare practices related to SUDI prevention messages in a New Zealand community, and to develop and explore the utility of a risk assessment instrument based on international guidelines and evidence.

Methods

Prospective longitudinal study of 209 infants recruited antenatally. Participant characteristics and infant care data were collected by questionnaire at: baseline (third trimester), and monthly from infant age 3 weeks through 23 weeks. Published meta-analyses data were used to estimate individual risk ratios for 6 important SUDI risk factors which, when combined, yielded a “SUDI risk score”.

Results

Most infants were at low risk for SUDI with 72% at the lowest or slightly elevated risk (combined risk ratio ≤1.5). There was a high prevalence of the safe practices: supine sleeping (86-89% over 3–19 weeks), mother not smoking (90-92% over 3–19 weeks), and not bed sharing at a young age (87% at 3 weeks). Five independent predictors of a high SUDI risk score were: higher parity (P =0.028), younger age (P =0.030), not working or caring for other children antenatally (P =0.031), higher depression scores antenatally (P =0.036), and lower education (P =0.042).

Conclusions

Groups within the community identified as priorities for education about safe sleep practices beyond standard care are mothers who are young, have high parity, low educational levels, and have symptoms of depression antenatally. These findings emphasize the importance of addressing maternal depression as a modifiable risk factor in pregnancy.

【 授权许可】

   
2014 Galland et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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