Hauck Fern R, Tanabe Kawai O
Departments of Family Medicine and Public Health Sciences, University of Virginia School of Medicine, Virginia, USA.
BMJ Clin Evid. 2009 Jun 5;2009:0315.
By definition, the cause of sudden infant death syndrome (SIDS) is not known. Observational studies have found an association between SIDS and several risk factors, including prone sleeping position, prenatal or postnatal exposure to tobacco smoke, soft sleeping surfaces, hyperthermia/overwrapping, bed sharing (particularly with mothers who smoke), lack of breastfeeding, and lack of soother use. The risk of SIDS is increased in families in which there has been a prior sudden infant death.
We conducted a systematic review and aimed to answer the following clinical question: What are the effects of interventions to reduce the risk of SIDS? We searched: Medline, Embase, The Cochrane Library, and other important databases up to April 2007 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
We found 28 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
In this systematic review, we present information relating to the effectiveness and safety of the following interventions: advice to avoid prone sleeping; advice to avoid tobacco-smoke exposure; advice to avoid soft sleeping surfaces; advice to avoid overheating or overwrapping; advice to avoid bed sharing; advice to breastfeed; advice to promote soother/pacifier use; and advice to promote room sharing (without bed sharing).
根据定义，婴儿猝死综合征（SIDS）的病因尚不清楚。观察性研究发现SIDS与多种风险因素之间存在关联，包括俯卧睡眠姿势、产前或产后接触烟草烟雾、柔软的睡眠表面、体温过高/包裹过度、同床睡眠（尤其是与吸烟的母亲同床）、缺乏母乳喂养以及未使用安抚奶嘴。在有过婴儿猝死先例的家庭中，SIDS的风险会增加。
我们进行了一项系统综述，旨在回答以下临床问题：降低SIDS风险的干预措施有哪些效果？我们检索了：截至2007年4月的Medline、Embase、Cochrane图书馆及其他重要数据库（《临床证据》综述会定期更新；请查看我们的网站获取本综述的最新版本）。我们纳入了来自美国食品药品监督管理局（FDA）和英国药品及保健品监管局（MHRA）等相关组织的危害警示。
我们找到了28项符合我们纳入标准的系统综述、随机对照试验或观察性研究。我们对干预措施的证据质量进行了GRADE评估。
在本系统综述中，我们提供了以下干预措施的有效性和安全性相关信息：避免俯卧睡眠的建议；避免接触烟草烟雾的建议；避免使用柔软睡眠表面的建议；避免过热或包裹过度的建议；避免同床睡眠的建议；母乳喂养的建议；促进使用安抚奶嘴的建议；以及促进分室睡眠（不同床）的建议。
