Fleming P J, Gilbert R, Azaz Y, Berry P J, Rudd P T, Stewart A, Hall E
Institute of Child Health, Bristol.
BMJ. 1990 Jul 14;301(6743):85-9. doi: 10.1136/bmj.301.6743.85.
To determine the relation between sleeping position and quantity of bedding and the risk of sudden unexpected infant death.
A study of all infants dying suddenly and unexpectedly and of two controls matched for age and date with each index case. The parents of control infants were interviewed within 72 hours of the index infant's death. Information was collected on bedding, sleeping position, heating, and recent signs of illness for index and control infants.
A defined geographical area comprising most of the county of Avon and part of Somerset.
72 Infants who had died suddenly and unexpectedly (of whom 67 had died from the sudden infant death syndrome) and 144 control infants.
Compared with the control infants the infants who had died from the sudden infant death syndrome were more likely to have been sleeping prone (relative risk 8.8; 95% confidence interval 7.0 to 11.0; p less than 0.001), to have been more heavily wrapped (relative risk 1.14 per tog above 8 tog; 1.03 to 1.28; p less than 0.05), and to have had the heating on all night (relative risk 2.7; 1.4 to 5.2; p less than 0.01). These differences were less pronounced in the younger infants (less than 70 days) than the older ones. The risk of sudden unexpected death among infants older than 70 days, nursed prone, and with clothing and bedding of total thermal resistance greater than 10 tog was increased by factors of 15.1 (2.6 to 89.6) and 25.2 (3.7 to 169.0) respectively compared with the risk in infants of the same age nursed supine or on their side and under less than 6 tog of bedding.
Overheating and the prone position are independently associated with an increased risk of sudden unexpected infant death, particularly in infants aged more than 70 days. Educating parents about appropriate thermal care and sleeping position of infants may help to reduce the incidence of the sudden infant death syndrome.
确定睡眠姿势、被褥数量与婴儿不明原因猝死风险之间的关系。
对所有不明原因猝死的婴儿以及与每个索引病例年龄和日期匹配的两名对照婴儿进行研究。对照婴儿的父母在索引婴儿死亡后72小时内接受访谈。收集索引婴儿和对照婴儿的被褥、睡眠姿势、取暖情况以及近期疾病迹象等信息。
一个明确的地理区域，包括埃文郡的大部分地区和萨默塞特郡的一部分。
72名不明原因猝死的婴儿（其中67名死于婴儿猝死综合征）和144名对照婴儿。
与对照婴儿相比，死于婴儿猝死综合征的婴儿更有可能俯卧睡眠（相对风险8.8；95%置信区间7.0至11.0；p<0.001），包裹得更严实（每超过8托热阻增加相对风险1.14；1.03至1.28；p<0.05），并且整晚都开着暖气（相对风险2.7；1.4至5.2；p<0.01）。这些差异在较小的婴儿（小于70天）中不如较大婴儿明显。与同龄仰卧或侧卧且被褥热阻小于6托的婴儿相比，70天以上俯卧睡眠且衣物和被褥总热阻大于10托的婴儿不明原因猝死风险分别增加了15.1倍（2.6至89.6）和25.2倍（3.7至169.0）。
过热和俯卧姿势与婴儿不明原因猝死风险增加独立相关，尤其是在70天以上的婴儿中。对父母进行关于婴儿适当保暖护理和睡眠姿势的教育可能有助于降低婴儿猝死综合征的发生率。
