title: Factors relating to the infant's last sleep environment in sudden infant death syndrome in the Republic of Ireland.
abstract: OBJECTIVE
  To identify risk factors for sudden infant death syndrome (SIDS) in the sleeping environment of Irish infants.
  
  
  METHODS
  A five year population based case-control study with parental interviews conducted for each case and three controls matched for age, place of birth, and last sleep period. A total of 203 SIDS cases and 622 control infants born 1994-98 were studied.
  
  
  RESULTS
  In a multivariate analysis, co-sleeping significantly increased the risk of SIDS both as a usual practice (adjusted OR 4.31; 95% CI 1.07 to 17.37) and during the last sleep period (adjusted OR 16.47; 95% CI 3.73 to 72.75). The associated risk was dependent on maternal smoking (OR 21.84; 95% CI 2.27 to 209.89), and was not significant for infants who were > or =20 weeks of age (OR 2.63; 95% CI 0.49 to 70.10) or placed back in their own cot/bed to sleep (OR 1.07; 95% CI 0.21 to 5.41). The use of pillows, duvets, and bedding with tog value > or =10 were not significant risk factors when adjusted for the effects of confounding variables, including maternal smoking and social disadvantage. However, the prone sleeping position remains a significant SIDS risk factor, and among infants using soothers, the absence of soother use during the last sleep period also significantly increased the SIDS risk (OR 5.83; CI 2.37 to 14.36).
  
  
  CONCLUSIONS
  Co-sleeping should be avoided in infants who are <20 weeks of age, or whose mothers smoked during pregnancy. The prone position remains a factor in some SIDS deaths, and the relation between soother use and SIDS is a complex variable requiring further study.
authors.affiliation: National Sudden Infant Death Register, The Children's Hospital, Temple Street, Dublin 1, Republic of Ireland. isidansr@tsch.ie
authors.forename: C
authors.initials: C
authors.lastname: McGarvey
authors.forename: M
authors.initials: M
authors.lastname: McDonnell
authors.forename: A
authors.initials: A
authors.lastname: Chong
authors.forename: M
authors.initials: M
authors.lastname: O'Regan
authors.forename: T
authors.initials: T
authors.lastname: Matthews
mesh_terms: D001513:Beds; D016022:Case-Control Studies; D003441:Crowding; D006801:Humans; D007223:Infant; D015370:Infant Equipment / Q000706:statistics & numerical data; D007494:Ireland / Q000453:epidemiology; D015999:Multivariate Analysis; D041361:Pacifiers / Q000706:statistics & numerical data; D015995:Prevalence; D016684:Prone Position; D012307:Risk Factors; D012890:Sleep; D013398:Sudden Infant Death / Q000453:epidemiology*