Sleep environment, positional, lifestyle, and demographic characteristics associated with bed sharing in sudden infant death syndrome cases: a population-based study.
BACKGROUND
In 2005, the American Academy of Pediatrics Task Force on Sudden Infant Death Syndrome recommended that infants not bed share during sleep.


OBJECTIVE
Our goal was to characterize the profile of risk factors associated with bed sharing in sudden infant death syndrome cases.


METHODS
We conducted a population-based retrospective review of sudden infant death syndrome cases in New Jersey (1996-2000) dichotomized by bed-sharing status and compared demographic, lifestyle, bedding-environment, and sleep-position status.


RESULTS
Bed-sharing status was reported in 239 of 251 cases, with sharing in 39%. Bed-sharing cases had a higher percentage of bedding risks (44.1% vs 24.7%), exposure to bedding risks in infants discovered prone (57.1% vs 28.2%), and lateral sleep placement (28.9% vs 17.8%). The prone position was more common for bed-sharing and non-bed-sharing cases at placement (45.8% and 51.1%, respectively) and discovery (59.0% and 64.4%, respectively). In multivariable logistic-regression analyses, black race, mother <19 years, gravida >2, and maternal smoking were associated with bed sharing. There was a trend toward less breastfeeding in bed-sharing cases (22% vs 35%). In bed-sharing cases, those breastfed were younger than those who were not and somewhat more exposed to bedding risks (64.7% vs 45.1%) but less likely to be placed prone (11.8% vs 52.9%) or have maternal smoking (33% vs 66%).


CONCLUSIONS
Bed-sharing cases were more likely to have had bedding-environment and sleep-position risks and higher ratios of demographic and lifestyle risk factors. Bed-sharing subjects who breastfed had a risk profile distinct from those who were not breastfed cases. Risk and situational profiles can be used to identify families in greater need of early guidance and to prepare educational content to promote safe sleep.
Ostfeld
Barbara M
BM
SIDS Center of New Jersey, Department of Pediatrics, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ 08903-0019, USA.
Perl
Harold
H
Esposito
Linda
L
Hempstead
Katherine
K
Hinnen
Robert
R
Sandler
Alissa
A
Pearson
Paula Goldblatt
PG
Hegyi
Thomas
T
D001513:Beds; D003710:Demography; D004777:Environment; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008019:Life Style; D011187:Posture; D012189:Retrospective Studies; D012307:Risk Factors; D012890:Sleep; D013398:Sudden Infant Death / Q000453:epidemiology*