Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Pediatrics
Published in: BMC Pediatrics 1/2019

Open Access 01-12-2019 | Sudden Infant Death Syndrome | Research article

Prevalence and associated factors of supine sleep position in 3-month-old infants: findings from the 2015 Pelotas (Brazil) Birth Cohort

Authors: Bruna Gonçalves C. da Silva, Mariângela Freitas da Silveira, Paula Duarte de Oliveira, Marlos Rodrigues Domingues, Nelson Arns Neumann, Fernando C. Barros, Andréa Dâmaso Bertoldi

Published in: BMC Pediatrics | Issue 1/2019

Login to get access

Abstract

Background

Non-supine infant sleep position is an important modifiable risk factor for sudden unexpected death in infancy. The aim of this study was to assess the prevalence of supine sleep position and associated factors among 3-month-old infants from a birth cohort in the city of Pelotas, southern Brazil.

Methods

The present study evaluated longitudinal data from the 2015 Pelotas Birth Cohort. Study outcome was supine infant sleep position, defined as the appropriate position, among 3-month-old children. Demographic, socioeconomic, behavioral, and health characteristics collected at birth and at the 3-month follow-up were investigated as possible associated factors. The prevalence of each associated factor was investigated, and crude and hierarchical adjusted analyses were performed using Poisson regression.

Results

Among the 4108 infants assessed in this study, 2274 (55.4%) slept in supine position at 3 months and only 66 (1.6%) in prone position. Maternal white skin color, higher family income and maternal schooling, advanced maternal age, maternal cohabiting with a partner, receiving counseling from health care professionals and non-bed-sharing were associated with higher prevalence of infants sleeping in supine position at 3 months. All these variables remained associated in our hierarchical adjusted analyses except maternal cohabitation with a partner. Participants with white mothers were more likely to sleep in supine position (PR: 1.23; 95%CI: 0.75–0.89) compared to participants with black mothers. Those belonging to the richest quintile were more likely to sleep in supine position (PR: 1.49; 95%CI: 1.35–1.65) compared to those who belong to the poorest. Mothers aged 31–36 years were more likely to choose supine sleep position (PR: 1.65; 95%CI: 1.42–1.92) compared to mothers younger than 19 years.

Conclusions

The findings of the present study showed the influence of maternal age, socioeconomic status, and counseling on infant sleep habits as predictors of choice of infant sleep position in a Brazilian population. It is recommended to implement informative campaigns and public policies to at-risk population and to improve recommendations from health care professionals.
Literature
1.
Thach BT. How does prone sleeping increase prevalence of sudden infant death syndrome? Pediatr Pulmonol. 1997;23:115–6.CrossRef
2.
Willinger M, James LS, Catz C. Defining the sudden infant death syndrome: deliberations of an expert panel convened by the National Institute of Child Health and Human Development. Pediatr Pathol. 1991;11:677.CrossRef
3.
Galland BC, Elder DE. Sudden unexpected death in infancy: biological mechanisms. Paediatr Respir Rev. 2014;15:287–92.PubMed
4.
Mitchell EA, Krous HF. Sudden unexpected death in infancy: a historical perspective. J Paediatr Child Health. 2015;51:108–12.CrossRef
5.
Stanley FJ, Byard RW. The association between the prone sleeping position and sudden infant death syndrome (SIDS): an editorial overview. J PaediatrChild Health. 1991;27:325–8.
6.
Moon RY, Horne RS, Hauck FR. Sudden infant death syndrome. Lancet. 2007;370:1578–87.CrossRef
7.
Hauck FR, Tanabe KO. International trends in sudden infant death syndrome: stabilization of rates requires further action. Pediatrics. 2008;122:660–6.CrossRef
8.
Colson ER, Rybin D, Smith LA, Colton T, Lister G, Corwin MJ. Trends and factors associated with infant sleeping position: the national infant sleep position study, 1993-2007. Arch Pediatr Adolesc Med. 2009;163:1122.CrossRef
9.
Lorea RL, Pilger MC, Ceia ML. Síndrome da morte súbita infantil em Pelotas de 2006 a 2013: uma análise descritiva. RevMedicina. 2017;96:27–31.
10.
11.
Taylor BJ, Garstang J, Engelberts A, Obonai T, Cote A, Freemantle J, et al. International comparison of sudden unexpected death in infancy rates using a newly proposed set of cause-of-death codes. Arch Dis Child. 2015;100:1018–23.CrossRef
12.
França E, Teixeira R, Ishitani L, Duncan BB, Cortez-Escalante JJ, OLd MN, et al. Ill-defined causes of death in Brazil: a redistribution method based on the investigation of such causes. Rev Saúde Pública. 2014;48:671–81.CrossRef
13.
Colson ER, Geller NL, Heeren T, Corwin MJ. Factors associated with choice of infant sleep position. Pediatrics. 2017;140:e20170596.CrossRef
14.
Chung EK, Hung YY, Marchi K, Chavez GF, Braveman P. Infant sleep position: associated maternal and infant factors. Ambul Pediatr. 2003;3:234–9.CrossRef
15.
Smylie J, Fell DB, Chalmers B, Sauve R, Royle C, Allan B, et al. Socioeconomic position and factors associated with use of a nonsupine infant sleep position: findings from the Canadian maternity experiences survey. Am J Public Health. 2014;104:539–47.CrossRef
16.
Anuntaseree W, Mo-Suwan L, Vasiknanonte P, Kuasirikul S, Ma ALA, Choprapawon C. Factors associated with bed sharing and sleep position in Thai neonates. Child Care Health Dev. 2008;34:482–90.CrossRef
17.
18.
Barros AJ, Hirakata VN. Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio. BMC Med Res Methodol. 2003;3:21.CrossRef
19.
Chung-Park MS. Knowledge, opinions, and practices of infant sleep position among parents. Mil Med. 2012;177:235–9.CrossRef
20.
Robida D, Moon RY. Factors influencing infant sleep position: decisions do not differ by SES in African-American families. Arch Dis Child. 2012;97:900–5.CrossRef
21.
Cesar JA, Acevedo JD, Kaczan CR, Venzo JCP, Costa LR, Silva L, et al. Identifying mothers' intention to place infant in supine sleep position: a population-based study. Cien Saude Colet. 2018;23:501–8.CrossRef
22.
23.
Spencer N, Logan S. Sudden unexpected death in infancy and socioeconomic status: a systematic review. J Epidemiol Community Health. 2004;58:366–73.CrossRef
24.
Hauck FR, Moore CM, Herman SM, Donovan M, Kalelkar M, Christoffel KK, et al. The contribution of prone sleeping position to the racial disparity in sudden infant death syndrome: the Chicago infant mortality study. Pediatrics. 2002;110:772–80.CrossRef
25.
McKinney CM, Holt VL, Cunningham ML, Leroux BG, Starr JR. Maternal and infant characteristics associated with prone and lateral infant sleep positioning in Washington state, 1996-2002. J Pediatr. 2008;153:194–8 8.e1-3.CrossRef
26.
Taylor JA, Davis RL. Risk factors for the infant prone sleep position. Arch Pediatr Adolesc Med. 1996;150:834–7.CrossRef
27.
Blair PS, Sidebotham P, Evason-Coombe C, Edmonds M, Heckstall-Smith EM, Fleming P. Hazardous cosleeping environments and risk factors amenable to change: case-control study of SIDS in south West England. BMJ. 2009;339:b3666.CrossRef
28.
Vennemann MM, Bajanowski T, Brinkmann B, Jorch G, Sauerland C, Mitchell EA. Sleep environment risk factors for sudden infant death syndrome: the German sudden infant death syndrome study. Pediatrics. 2009;123:1162–70.CrossRef
29.
Fleming P, Pease A, Blair P. Bed-sharing and unexpected infant deaths: what is the relationship? Paediatr Respir Rev. 2015;16(1):62–7.PubMed
30.
Willinger M, Ko CW, Hoffman HJ, Kessler RC, Corwin MJ. Trends in infant bed sharing in the United States, 1993-2000: the National Infant Sleep Position study. Arch Pediatr Adolesc Med. 2003;157:43–9.CrossRef
31.
Colson ER, Willinger M, Rybin D, Heeren T, Smith LA, Lister G, et al. Trends and factors associated with infant bed sharing, 1993-2010: the National Infant Sleep Position Study. JAMA Pediatr. 2013;167:1032–7.CrossRef
32.
Vernacchio L, Corwin MJ, Lesko SM, Vezina RM, Hunt CE, Hoffman HJ, et al. Sleep position of low birth weight infants. Pediatrics. 2003;111:633–40.CrossRef
33.
Von Kohorn I, Corwin MJ, Rybin DV, Heeren TC, Lister G, Colson ER. Influence of prior advice and beliefs of mothers on infant sleep position. Arch Pediatr Adolesc Med. 2010;164:363–9.
34.
Zachry AH, Kitzmann KM. Disparities in sleep position awareness and compliance. South Med J. 2010;103:311–5.CrossRef
35.
Geib LTC, Nunes ML. Hábitos de sono relacionados à síndrome da morte súbita do lactente: estudo populacional. Cad Saude Publica. 2006;22:415–23.CrossRef
36.
Blair PS, Pease AS, Fleming PJ. Observational investigations from England: the CESDI and SWISS studies. In: Duncan JR, Byard RW, editors. SIDS sudden infant and early childhood death: the past, the present and the future. Adelaide (AU): University of Adelaide press; 2018. p. 325–47.
Metadata
Title
Prevalence and associated factors of supine sleep position in 3-month-old infants: findings from the 2015 Pelotas (Brazil) Birth Cohort
Authors
Bruna Gonçalves C. da Silva
Mariângela Freitas da Silveira
Paula Duarte de Oliveira
Marlos Rodrigues Domingues
Nelson Arns Neumann
Fernando C. Barros
Andréa Dâmaso Bertoldi
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2019
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-019-1534-3

Other articles of this Issue 1/2019

BMC Pediatrics 1/2019 Go to the issue

Study protocol

Early prediction of spontaneous Patent Ductus Arteriosus (PDA) closure and PDA-associated outcomes: a prospective cohort investigation

Correction

Correction to: Breastfeeding and timing of pubertal onset in girls: a multiethnic population-based prospective cohort study

Case report

Clinical analysis of a case of neonatal exfoliative esophagitis in an 18-day-old neonate

Debate

Challenges of training and delivery of pediatric surgical services in developing economies: a perspective from Pakistan

Research article

Practice variation in anti-epileptic drug use for neonatal hypoxic-ischemic encephalopathy among regional NICUs

Research article

ICU admission following an unscheduled return visit to the pediatric emergency department within 72 hours