Paris C A, Remler R, Daling J R
Division of Pediatric Emergency Medicine, Children's Hospital and Regional Medical Center, Seattle, Washington 98105, USA.
J Pediatr. 2001 Dec;139(6):771-7. doi: 10.1067/mpd.2001.118568.
To quantify the decreased incidence of sudden infant death syndrome (SIDS) and investigate risk profile changes associated with changes in infant sleep position.
A population-based case-control study that used birth and death certificates from Washington State. Cases (n = 1515) were all singletons born in Washington between 1985 and 1995 (excluding 1991) who died of SIDS. Control cases (n = 6060) were randomly selected singletons born in the same period who did not die of SIDS. Multivariate logistic regression compared changes in the magnitude of associations between risk factors and SIDS before and after 1991.
The incidence of SIDS in Washington declined from 2.6 (1985) to 1.0 (1998) per 1000 births. Over time, the risk of SIDS increased for low birth weight infants (odds ratio [OR] 2.1 rose to 3.6), and infants born to mothers who were smokers (OR 2.7 rose to 3.7), unmarried (OR 1.4 rose to 2.0), black (OR 1.4 rose to 2.5), or received limited prenatal care (OR 1.5 rose to 2.5).
Five exposures were associated with increased risks of SIDS. These may not require a prone sleep position for their deleterious impact being associated with distinct causal pathways, or possibly indicating subpopulations yet to recognize the importance of the supine sleep position.
量化婴儿猝死综合征（SIDS）发病率的下降情况，并调查与婴儿睡眠姿势变化相关的风险特征变化。
一项基于人群的病例对照研究，使用了华盛顿州的出生和死亡证明。病例组（n = 1515）为1985年至1995年（不包括1991年）在华盛顿出生并死于SIDS的所有单胎婴儿。对照组（n = 6060）是同期随机选取的未死于SIDS的单胎婴儿。多因素逻辑回归比较了1991年前后风险因素与SIDS之间关联强度的变化。
华盛顿州SIDS的发病率从每1000例出生2.6例（1985年）降至1.0例（1998年）。随着时间的推移，低体重婴儿（比值比[OR]从2.1升至3.6）、母亲为吸烟者的婴儿（OR从2.7升至3.7）、未婚母亲的婴儿（OR从1.4升至2.0）、黑人婴儿（OR从1.4升至2.5）或接受有限产前护理的婴儿（OR从1.5升至2.5）患SIDS的风险增加。
五种暴露因素与SIDS风险增加相关。这些因素可能因其有害影响与不同的因果途径相关，不需要俯卧睡眠姿势，或者可能表明亚人群尚未认识到仰卧睡眠姿势的重要性。
