Li De-Kun, Willinger Marian, Petitti Diana B, Odouli Roxana, Liu Liyan, Hoffman Howard J
Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612, USA.
BMJ. 2006 Jan 7;332(7532):18-22. doi: 10.1136/bmj.38671.640475.55. Epub 2005 Dec 9.
To examine the association between use of a dummy (pacifier) during sleep and the risk of sudden infant death syndrome (SIDS) in relation to other risk factors.
Population based case-control study.
Eleven counties in California.
Mothers or carers of 185 infants whose deaths were attributed to SIDS and 312 randomly selected controls matched for race or ethnicity and age.
Use of a dummy during sleep determined through interviews.
The adjusted odds ratio for SIDS associated with using a dummy during the last sleep was 0.08 (95% confidence interval 0.03 to 0.21). Use was associated with a reduction in risk in every category of sociodemographic characteristics and risk factors examined. The reduced risk associated with use seemed to be greater with adverse sleep conditions (such as sleeping prone or on side and sleeping with a mother who smoked), although the observed interactions were not significant. In addition, use of a dummy may reduce the impact of other risk factors for SIDS, especially those related to adverse sleep environment. For example, infants who did not use a dummy and slept prone or on their sides (v on their back) had an increased risk of SIDS (2.61, 1.56 to 4.38). In infants who used dummies, there was no increased risk associated with sleeping position (0.66, 0.12 to 3.59). While cosleeping with a mother who smoked was also associated with increased risk of SIDS among infants who did not use a dummy (4.5, 1.3 to 15.1), there was no such association among those who did (1.1, 0.1 to 13.4).
Use of a dummy seems to reduce the risk of SIDS and possibly reduces the influence of known risk factors in the sleep environment.
探讨睡眠期间使用安抚奶嘴与婴儿猝死综合征（SIDS）风险之间的关联，并与其他风险因素进行比较。
基于人群的病例对照研究。
加利福尼亚州的11个县。
185名死亡归因于SIDS的婴儿的母亲或照顾者，以及312名按种族或民族和年龄匹配的随机选择的对照。
通过访谈确定睡眠期间使用安抚奶嘴的情况。
上次睡眠期间使用安抚奶嘴与SIDS相关的校正比值比为0.08（95%置信区间0.03至0.21）。在所检查的每一类社会人口学特征和风险因素中，使用安抚奶嘴都与风险降低相关。与使用安抚奶嘴相关的风险降低在不良睡眠条件下（如俯卧或侧卧睡眠以及与吸烟母亲同睡）似乎更大，尽管观察到的交互作用不显著。此外，使用安抚奶嘴可能会降低其他SIDS风险因素的影响，尤其是那些与不良睡眠环境相关的因素。例如，不使用安抚奶嘴且俯卧或侧卧睡眠（相对于仰卧睡眠）的婴儿患SIDS的风险增加（2.61，1.56至4.38）。在使用安抚奶嘴的婴儿中，睡眠姿势与风险增加无关（0.66，0.12至3.59）。虽然与吸烟母亲同睡也与不使用安抚奶嘴的婴儿患SIDS的风险增加相关（4.5，1.3至15.1），但在使用安抚奶嘴的婴儿中则无此关联（1.1，0.1至13.4）。
使用安抚奶嘴似乎可降低SIDS风险，并可能减少睡眠环境中已知风险因素的影响。
