BRITISH COLUMBIA – Since 1994, parents have been urged to put their babies to
sleep on their backs to reduce the risk of sudden infant death syndrome (SIDS).
It appears many caregivers have not gotten the message, and health care providers
have not done enough to educate families.
supine sleeping (being placed on the back for sleep) are
as low as 50 percent in some states, according to a study to be presented
Saturday, May 3, at the Pediatric Academic Societies (PAS) annual meeting in
Vancouver, British Columbia, Canada. In addition, only
about two-thirds of term infants nationwide are placed on their backs to sleep,
and the rate is even lower among preterm infants.
“Given that supine sleep positioning significantly reduces an
infant’s risk for SIDS, it is worrisome that only two-thirds of full-term
infants born in the U.S. are being placed back-to-sleep,” said lead author
Sunah S. Hwang, MD, MPH, FAAP, a neonatologist at Boston Children’s Hospital
and South Shore Hospital, and instructor in pediatrics at Harvard Medical
School. “More concerning is that adherence to safe sleep positioning is even
lower for preterm infants who are at even greater risk for SIDS compared to
SIDS is the leading cause of death
among infants between 1 month and 1 year of age.
More than 2,000 babies died from
SIDS in 2010, the most recent year statistics are available from the Centers
for Disease Control and Prevention (CDC).
“Although the precise cause of SIDS is still unknown, we do know
that safe sleep practices, such as sleeping on the back, reduces the risk of
infant death in the first year of life,” Dr. Hwang said. “The Back-to-Sleep
campaign reduced the rate of SIDS by 50 percent in the 1990s. Since 2001, this
rate has remained stagnant.”
Dr. Hwang and her colleagues analyzed
data from the Pregnancy Risk Assessment Monitoring System (PRAMS) to compare
the prevalence of supine sleep positioning after hospital discharge for preterm
and term infants. PRAMS is a state-based surveillance system funded by the CDC to
monitor behaviors and experiences among women who recently delivered a
live-born infant in a hospital. Surveys are mailed to mothers, and those who do
not respond are contacted by phone. Mothers
were asked which position they usually put their infant to sleep (side, back,
stomach). Responses were categorized as supine (back) and non-supine, which
included a combination of sleep positions.
The study included 392,397 infants born in 36 states, which had
response rates of 70 percent or more in 2000-2011. Researchers analyzed supine
sleeping in the following gestational age categories: 27 weeks or less, 28-33
weeks, 34-36 weeks and 37-42 weeks.
Results showed both preterm and term infants had suboptimal rates of
supine sleep positioning after hospital discharge. In addition, supine sleep
positioning varied widely by state, with Alabama having the lowest rate at 50
percent and Wisconsin having the highest rate at 81 percent.
The most preterm group of infants (less than 28 weeks) had the
lowest rate of supine sleep positioning at 60 percent. After adjusting for
maternal age, education, race/Hispanic ethnicity, marital status, previous live
birth, insurance status before pregnancy, method of delivery and maternal
length of hospital stay, late preterm infants (34-36 weeks) were significantly
less likely to sleep on their backs compared to term infants.
the concerning data about inadequate adherence to safe sleep practices for all
infants and in particular for preterm infants, we
need to better engage families about adhering to safe sleep practices at the
individual, community, hospital and public health levels,” Dr. Hwang
will present “Supine Sleep Positioning in Preterm and Term Infants After
Hospital Discharge in 36 States, 2000-2011” from 3:15-3:30 p.m. Saturday, May
3. To view the study abstract, go to www.abstracts2view.com/pas/view.php?nu=PAS14L1_1690.3.
outside funding was received for this research.
Academic Societies (PAS) are four individual pediatric organizations that
co-sponsor the PAS Annual Meeting – the American Pediatric Society, the Society
for Pediatric Research, the Academic Pediatric Association, and the American
Academy of Pediatrics. Members of these organizations are pediatricians and
other health care providers who are practicing in the research, academic and
clinical arenas. The four sponsoring organizations are leaders in the
advancement of pediatric research and child advocacy within pediatrics, and all
share a common mission of fostering the health and well-being of children
For more information, visit www.pas-meeting.org. Follow news of the PAS meeting on Twitter at http://twitter.com/PedAcadSoc.