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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >The contribution of prone sleeping position to the racial disparity in sudden infant death syndrome: the Chicago Infant Mortality Study.
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The contribution of prone sleeping position to the racial disparity in sudden infant death syndrome: the Chicago Infant Mortality Study.

机译：俯卧的睡眠姿势对婴儿猝死综合征中种族差异的贡献：《芝加哥婴儿死亡率研究》。

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BACKGROUND: Rates of sudden infant death syndrome (SIDS) are over twice as high among African Americans compared with Caucasians. Little is known, however, about the relationship between prone sleeping, other sleep environment factors, and the risk of SIDS in the United States and how differences in risk factors may account for disparities in mortality. OBJECTIVE: To assess the contribution of prone sleeping position and other potential risk factors to SIDS risk in a primarily high-risk, urban African American population. DESIGN, SETTING, AND POPULATION: Case-control study consisting of 260 infants ages birth to 1 year who died of SIDS between November 1993 and April 1996. The control group consists of an equal number of infants matched on race, age, and birth weight. Prospectively collected data from the death scene investigation and a follow-up home interview for case infants were compared with equivalent questions for living control participants to identify risk factors for SIDS. MAIN OUTCOME MEASURES: Risk of SIDS related to prone sleeping position adjusting for potential confounding variables and other risk factors for SIDS, and comparisons by race-ethnicity. RESULTS: Three quarters of the SIDS infants were African American. There was more than a twofold increased risk of SIDS associated with being placed prone for last sleep compared with the nonprone positions (odds ratio [OR]: 2.4; 95% confidence interval [CI]: 1.6-3.7). This OR increased after adjusting for potential confounding variables and other sleep environment factors (OR: 4.0; 95% CI: 1.8-8.8). Differences were found for African Americans compared with others (OR: 1.8; 95% CI: 1.2-2.6 and OR: 10.3, 95% CI: 10.3 [3.2-33.8, respectively]). The population attributable risk was 31%. Fewer case mothers (46%) than control mothers (64%) reported being advised about sleep position in the hospital after delivery. Of those advised, a similar proportion of case mothers as control mothers were incorrectly told or recalled being told to use the prone position, but prone was recommended in a higher proportion of black mothers (cases and controls combined) compared with nonblack mothers. CONCLUSIONS: Prone sleeping was found to be a significant risk factor for SIDS in this primarily African American urban sample, and approximately one third of the SIDS deaths could be attributed to this factor. Greater and more effective educational outreach must be extended to African American families and the health personnel serving them to reduce prone prevalence during sleep, which appears, in part, to contribute to the higher rates of SIDS among African American infants.
机译：背景：非裔美国人的婴儿猝死综合症（SIDS）的发病率是高加索人的两倍。然而，关于俯卧睡眠，其他睡眠环境因素与美国SIDS风险之间的关系以及风险因素的差异如何解释死亡率差异的了解甚少。目的：评估俯卧的睡眠姿势和其他潜在危险因素对主要属于高危城市非洲裔美国人的小岛屿发展中国家风险的影响。设计，地点和人口：病例对照研究包括1993年11月至1996年4月之间死于小岛屿发展中国家的260名1岁以下的婴儿。对照组由种族，年龄和出生体重匹配的同等数量的婴儿组成。将死亡现场调查和家庭婴儿的后续家庭访谈中收集的前瞻性数据与生活控制参与者的同等问题进行比较，以确定SIDS的危险因素。主要观察指标：SIDS的风险与俯卧的睡眠姿势有关，以调整潜在的混杂变量和其他SIDS危险因素，并按种族进行比较。结果：SIDS婴儿中有四分之三是非洲裔美国人。与非俯卧位相比，最后一次入睡倾向于SIDS的风险增加了两倍以上（几率[OR]：2.4; 95％置信区间[CI]：1.6-3.7）。在调整了潜在的混杂变量和其他睡眠环境因素后，该OR增加（OR：4.0; 95％CI：1.8-8.8）。非裔美国人与其他人相比存在差异（OR：1.8; 95％CI：1.2-2.6和OR：10.3，95％CI：10.3 [分别为3.2-33.8]）。人口归因风险为31％。据报告，分娩后被告知关于医院睡眠状况的病例母亲（46％）少于对照母亲（64％）。在被劝告的人中，有类似比例的案例母亲被错误告知或回忆起被告知要使用俯卧位，但与非黑人母亲相比，被推荐的黑人母亲比例更高（包括案例和对照）。结论：在这个主要是非裔美国人的城市样本中，俯卧睡眠被发现是SIDS的重要危险因素，SIDS死亡人数的大约三分之一可归因于这一因素。必须向非裔美国人家庭和为他们服务的卫生人员扩大更大范围和更有效的教育范围，以减少睡眠中俯卧患病率，这在一定程度上似乎是造成非裔美国人婴儿SIDS发生率较高的原因。

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