Parent-Infant Sleep Lab & Medical Anthropology Research Group, Department of Anthropology, Durham University, UK.
Paediatr Perinat Epidemiol. 2012 Jan;26(1):3-12. doi: 10.1111/j.1365-3016.2011.01217.x. Epub 2011 Aug 18.
In the UK, infants of South Asian parents have a lower rate of sudden infant death syndrome (SIDS) than White British infants. Infant care and life style behaviours are strongly associated with SIDS risk. This paper describes and explores variability in infant care between White British and South Asian families (of Bangladeshi, Indian or Pakistani origin) in Bradford, UK (the vast majority of which were Pakistani) and identifies areas for targeted SIDS intervention. A cross-sectional telephone interview study was conducted involving 2560 families with 2- to 4-month-old singleton infants enrolled in the Born in Bradford cohort study. Outcome measures were prevalence of self-reported practices in infant sleeping environment, sharing sleep surfaces, breast feeding, use of dummy or pacifier, and life style behaviours. We found that, compared with White British infants, Pakistani infants were more likely to: sleep in an adult bed (OR = 8.48 [95% CI 2.92, 24.63]); be positioned on their side for sleep (OR = 4.42 [2.85, 6.86]); have a pillow in their sleep environment (OR = 9.85 [6.39, 15.19]); sleep under a duvet (OR = 3.24 [2.39, 4.40]); be swaddled for sleep (OR = 1.49 [1.13, 1.97]); ever bed-share (OR = 2.13 [1.59, 2.86]); regularly bed-share (OR = 3.57 [2.23, 5.72]); ever been breast-fed (OR = 2.00 [1.58, 2.53]); and breast-fed for 8+ weeks (OR = 1.65 [1.31, 2.07]). Additionally, Pakistani infants were less likely to: sleep in a room alone (OR = 0.05 [0.03, 0.09]); use feet-to-foot position (OR = 0.36 [0.26, 0.50]); sleep with a soft toy (OR = 0.52 [0.40, 0.68]); use an infant sleeping bag (OR = 0.20 [0.16, 0.26]); ever sofa-share (OR = 0.22 [0.15, 0.34]); be receiving solid foods (OR = 0.22 [0.17, 0.30]); or use a dummy at night (OR = 0.40 [0.33, 0.50]). Pakistani infants were also less likely to be exposed to maternal smoking (OR = 0.07 [0.04, 0.12]) and to alcohol consumption by either parent. No difference was found in the prevalence of prone sleeping (OR = 1.04 [0.53, 2.01]). Night-time infant care therefore differed significantly between South Asian and White British families. South Asian infant care practices were more likely to protect infants from the most important SIDS risks such as smoking, alcohol consumption, sofa-sharing and solitary sleep. These differences may explain the lower rate of SIDS in this population.
在英国，南亚裔父母的婴儿患婴儿猝死综合征（SIDS）的比例低于白种英国婴儿。婴儿护理和生活方式行为与 SIDS 风险密切相关。本文描述并探讨了英国布拉德福德（绝大多数为巴基斯坦裔）的白种英国人和南亚裔家庭（孟加拉裔、印度裔或巴基斯坦裔）之间在婴儿护理方面的差异，并确定了 SIDS 干预的重点领域。一项横断面电话访谈研究纳入了布拉德福德出生队列研究中 2560 名 2-4 个月大的单胎婴儿的家庭。结果指标为婴儿睡眠环境中自我报告的实践、共享睡眠表面、母乳喂养、使用奶嘴或安抚奶嘴以及生活方式行为的流行率。我们发现，与白种英国婴儿相比，巴基斯坦婴儿更有可能：睡在成人床上（OR = 8.48 [95%CI 2.92, 24.63]）；侧卧睡觉（OR = 4.42 [2.85, 6.86]）；睡在有枕头的环境中（OR = 9.85 [6.39, 15.19]）；睡在羽绒被下（OR = 3.24 [2.39, 4.40]）；被襁褓包裹着睡觉（OR = 1.49 [1.13, 1.97]）；曾经与父母同床睡觉（OR = 2.13 [1.59, 2.86]）；经常与父母同床睡觉（OR = 3.57 [2.23, 5.72]）；曾经母乳喂养过（OR = 2.00 [1.58, 2.53]）；并母乳喂养 8 周以上（OR = 1.65 [1.31, 2.07]）。此外，巴基斯坦婴儿更不可能：独自睡在一个房间里（OR = 0.05 [0.03, 0.09]）；采用脚对脚的姿势（OR = 0.36 [0.26, 0.50]）；与柔软的玩具一起睡觉（OR = 0.52 [0.40, 0.68]）；使用婴儿睡袋（OR = 0.20 [0.16, 0.26]）；曾经在沙发上睡觉（OR = 0.22 [0.15, 0.34]）；正在接受固体食物（OR = 0.22 [0.17, 0.30]）；或夜间使用奶嘴（OR = 0.40 [0.33, 0.50]）。巴基斯坦婴儿也较少接触到母亲吸烟（OR = 0.07 [0.04, 0.12]）和父母任何一方饮酒。俯卧睡觉的流行率没有差异（OR = 1.04 [0.53, 2.01]）。因此，南亚裔和白种英国家庭的夜间婴儿护理有显著差异。南亚裔的婴儿护理方法更有可能保护婴儿免受吸烟、饮酒、沙发共享和单独睡眠等最重要的 SIDS 风险的影响。这些差异可能解释了该人群中 SIDS 发生率较低的原因。
