Malloy Michael H, Freeman Daniel H
Department of Pediatrics and the Office of Biostatistics, University of Texas Medical Branch, Galveston, TX 77555-0526, USA.
Arch Pediatr Adolesc Med. 2004 Apr;158(4):359-65. doi: 10.1001/archpedi.158.4.359.
In June 1992, the American Academy of Pediatrics Task Force on Infant Positioning and Sudden Infant Death Syndrome (SIDS) made its first recommendation concerning placing infants in a supine position. Since the publication of this recommendation, SIDS rates in the United States have declined 44%. Before this recommendation, SIDS had a marked seasonal pattern and was noted to occur more frequently on weekends.
The objective of this study was to determine if significant changes in SIDS rates have occurred in age at death (0-27 days vs 1-6 months vs 7-11 months), season of death, and weekday of death since the implementation of the recommendations for supine positioning of infants for sleep.
United States natality and mortality data were used for the years 1992 through 1994. United States linked infant birth and death certificate files were used for the years 1995 through 1999. Season of death was calculated from month of death and was ordered for analysis from winter to fall to spring to summer; day of death was ordered from Monday to Sunday and additionally analyzed as weekend (Saturday and Sunday) vs weekday (Monday through Friday).
During the 8 years, 28 548 deaths were attributed to SIDS among residents of the United States. The average annual decrease in the SIDS rate for neonates aged 0 to 27 days was 6.6%; for infants aged 1 to 6 months, 9.0%; and for infants aged 7 to 11 months, 6.1%. The average decline in seasonal rates from winter to summer was 11.2% per season. A significant interaction between year of death and season indicated a diminishing rate of seasonal variation. The odds ratio for weekend vs weekday SIDS deaths was 0.98 (95% confidence interval, 0.96-1.01). There was no significant interaction between year of death and weekday of death, which indicates no change in the relationship since the implementation of the supine sleeping recommendations.
These data provide insights into the effect of the supine sleep recommendations on SIDS. The reduction in seasonal variation of SIDS suggests advantages conferred by supine sleeping in colder seasons.
1992年6月，美国儿科学会婴儿睡眠姿势与婴儿猝死综合征（SIDS）特别工作组首次提出关于让婴儿仰卧睡觉的建议。自该建议发布以来，美国的婴儿猝死综合征发生率下降了44%。在这一建议发布之前，婴儿猝死综合征有明显的季节性模式，且在周末发生得更为频繁。
本研究的目的是确定自实施婴儿睡眠时仰卧姿势的建议以来，婴儿猝死综合征发生率在死亡年龄（0至27天、1至6个月、7至11个月）、死亡季节和死亡工作日方面是否发生了显著变化。
使用了1992年至1994年的美国出生和死亡数据。1995年至1999年使用了美国关联的婴儿出生和死亡证明文件。死亡季节根据死亡月份计算，并按冬季、秋季、春季、夏季的顺序进行分析；死亡日期按周一至周日的顺序排列，并进一步分析为周末（周六和周日）与工作日（周一至周五）。
在这8年中，美国居民中有28548例死亡归因于婴儿猝死综合征。0至27天新生儿的婴儿猝死综合征发生率平均每年下降6.6%；1至6个月婴儿为9.0%；7至11个月婴儿为6.1%。从冬季到夏季，季节性发生率的平均下降幅度为每个季节11.2%。死亡年份与季节之间存在显著交互作用，表明季节性变化率在降低。周末与工作日婴儿猝死综合征死亡的比值比为0.98（95%置信区间，0.96 - 1.01）。死亡年份与死亡工作日之间没有显著交互作用，这表明自实施仰卧睡眠建议以来，这种关系没有变化。
这些数据为仰卧睡眠建议对婴儿猝死综合征的影响提供了见解。婴儿猝死综合征季节性变化的减少表明仰卧睡眠在较寒冷季节具有优势。
