Infant sleep position: a randomized clinical trial of an educational intervention in the maternity ward in Porto Alegre, Brazil.
BACKGROUND
Few studies in Brazil have been published about sudden infant death syndrome (SIDS), and none has addressed the mother's orientation about placing the infant to sleep in the supine position. The aim of this study was to evaluate the effect on mothers of an individual educational intervention in the maternity ward about infant sleep position.


METHODS
A randomized clinical trial was conducted with a study sample of 228 mother-infant pairs assigned to an intervention or a control group. The intervention consisted of an individual orientation session at the maternity ward, at which folders and an oral explanation were given to mothers at discharge about the importance of the supine position as a preventive measure for SIDS. The outcome was the sleeping position at 3 months of age assessed during a home visit. The variables with p< 0.2 at a bivariate analysis were included in a logistic regression model.


RESULTS
Among mothers in the intervention group, 42.9 percent put their infants to sleep in a supine position at the 3-month visit, compared with 24 percent of mothers in the control group (p = 0.009). In a multivariate analysis, the intervention at the hospital was the only variable that influenced maternal practices with respect to infant sleep positioning (OR 2.22; 95% CI 1.17-4.19).


CONCLUSIONS
An individual educational session in the maternity ward about infant sleep position significantly increased the prevalence of supine position for sleeping in the infant's third month. Nevertheless, the intervention was not sufficient to guarantee that most mothers would put their infants to sleep in the recommended position.
Issler
Roberto Mário Silveira
RM
Professor in the Department of Pediatrics, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre 90035-003, Brazil. robertoissler@terra.com.br
Marostica
Paulo José Cauduro
PJ
Giugliani
Elsa Regina Justo
ER
D000328:Adult; D001938:Brazil; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D007224:Infant Care / Q000379:methods; D007231:Infant, Newborn; D008297:Male; D009035:Mothers / Q000193:education* / Q000523:psychology; D015999:Multivariate Analysis; D010353:Patient Education as Topic / Q000379:methods*; D015397:Program Evaluation; D012890:Sleep; D012959:Socioeconomic Factors; D013398:Sudden Infant Death / Q000517:prevention & control*; D016683:Supine Position; D011795:Surveys and Questionnaires; D055815:Young Adult