Das Rashmi Ranjan, Sankar M Jeeva, Agarwal Ramesh, Paul Vinod Kumar
Department of Pediatrics, All India Institute of Medical Sciences, Bhubaneswar 751019, India.
Newborn Health and Knowledge Centre (NHKC), Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India.
Int J Pediatr. 2014;2014:468538. doi: 10.1155/2014/468538. Epub 2014 Jan 30.
Background. There is conflicting evidence regarding the safety and efficacy of bed sharing during infancy-while it has been shown to facilitate breastfeeding and provide protection against hypothermia, it has been identified as a risk factor for SIDS. Methods. A systematic search of major databases was conducted. Eligible studies were observational studies that enrolled infants in the first 4 weeks of life and followed them up for a variable period of time thereafter. Results. A total of 21 studies were included. Though the quality of evidence was low, bed sharing was found to be associated with higher breastfeeding rates at 4 weeks of age (75.5% versus 50%, OR 3.09 (95% CI 2.67 to 3.58), P = 0.043) and an increased risk of SIDS (23.3% versus 11.2%, OR 2.36 (95% CI 1.97 to 2.83), P = 0.025). Majority of the studies were from developed countries, and the effect was almost consistent across the studies. Conclusion. There is low quality evidence that bed sharing is associated with higher breast feeding rates at 4 weeks of age and an increased risk of SIDS. We need more studies that look at bed sharing, breast feeding, and hazardous circumstance that put babies at risk.
背景。关于婴儿期同床睡眠的安全性和有效性存在相互矛盾的证据——虽然已表明同床睡眠有助于母乳喂养并预防体温过低,但它已被确定为婴儿猝死综合征的一个风险因素。方法。对主要数据库进行了系统检索。符合条件的研究为观察性研究,这些研究纳入了出生后4周内的婴儿,并在之后的一段可变时间内对他们进行随访。结果。共纳入21项研究。尽管证据质量较低,但发现同床睡眠与4周龄时较高的母乳喂养率相关(75.5%对50%,比值比3.09(95%置信区间2.67至3.58),P = 0.043)以及婴儿猝死综合征风险增加相关(23.3%对11.2%,比值比2.36(95%置信区间1.97至2.83),P = 0.025)。大多数研究来自发达国家,且各项研究的结果几乎一致。结论。有低质量证据表明同床睡眠与4周龄时较高的母乳喂养率以及婴儿猝死综合征风险增加相关。我们需要更多研究来关注同床睡眠、母乳喂养以及使婴儿面临风险的危险情况。