Environmental risk factors for sudden infant death syndrome in Japan.
While the prevalence of sudden infant death syndrome (SIDS) has decreased worldwide, this decline has plateaued recently. Strategies are needed to resume the constant decrease of SIDS in Japan. A prospective electrocardiographic screening program for infants was performed between July 2010 and March 2011. Parents of 4319 infants were asked about environmental factors related to SIDS through questionnaires at a one-month medical checkup and one year. Parental awareness of prone position, smoke exposure, and breast feeding as environmental factors were 81.4 %, 69.0 %, and 47.8 %, respectively. The prevalence of laying infants exclusively in a supine position was 96.7 %. At the one-month medical checkup, smoking prevalence was 41.7 % in fathers and 2.1 % in mothers. Maternal smoking prevalence was significantly increased at one year after (p < 0.001). Multivariate regression analysis showed that risk factors for new or continued maternal smoking habits were maternal smoking habits at one month (p < 0.001), paternal smoking habits one year later (p < 0.001), and younger maternal age (p = 0.02).


CONCLUSIONS
Most parents already avoid laying infants in the prone position, and parental smoking is still a SIDS risk concern in Japan. Smoking cessation programs should be further implemented for parents to decrease risks of SIDS in Japan. What is Known: • The prevalence of sudden infant death syndrome (SIDS) has decreased worldwide, however, this decline has plateaued recently. What is New: • Most infants were laid sleeping in the supine position (96.7 %) and were fed breast milk or a mix of expressed milk and formula (92.7 %), and 2.1 % of mothers smoked at the one-month medical checkup. • Maternal smoking prevalence significantly increased from the one-month medical checkup to one year later, and smoking mothers were more likely to feed infants by formula rather than breast milk. • Independent risk factors for new or continued maternal smoking habits included younger maternal age, maternal smoking habits at one month, and paternal smoking habits one year later.
Department of Pediatrics, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan.
Masako
M
Hirabayashi
Department of Pediatrics, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan.
Masao
M
Yoshinaga
Department of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences, 37-1 Uearata-cho, Kagoshima, 890-8760, Japan. uichiyuichi@gmail.com.|Department of Pediatrics, Kagoshima City Hospital, Kagoshima, Japan. uichiyuichi@gmail.com.
Yuichi
Y
Nomura
Department of the Cardiovascular System, Fukuoka Children's Hospital and Medical Center for Infectious Diseases, Fukuoka, Japan.
Hiroya
H
Ushinohama
Department of Pediatrics, Niigata City General Hospital, Niigata, Japan.
Seiichi
S
Sato
Department of Rehabilitation, Aichi Saiseikai Rehabilitation Hospital, Nagoya, Japan.
Nobuo
N
Tauchi
Departments of Child Health, University of Tsukuba, Tsukuba, Japan.
Hitoshi
H
Horigome
Department of Information Management and Statistics, School of Medicine, Fukushima Medical University, Fukushima, Japan.
Hideto
H
Takahashi
Department of Pediatric Cardiology, Saitama International Medical Center, Hidaka, Japan.
Naokata
N
Sumitomo
International Pediatric Center Josai Hospital, Ibaraki, Japan.
Hirohiko
H
Shiraishi
Department of Pediatrics, Niigata City General Hospital, Niigata, Japan.
Masami
M
Nagashima
D000328:Adult; D001942:Breast Feeding / Q000706:statistics & numerical data; D016009:Chi-Square Distribution; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007564:Japan / Q000453:epidemiology; D008297:Male; D010290:Parents; D015995:Prevalence; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D013398:Sudden Infant Death / Q000453:epidemiology*; D016683:Supine Position; D011795:Surveys and Questionnaires
Breast feeding; Infant formula; Parents; Smoking; Sudden infant death
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