Moon Rachel Y, Mathews Anita, Joyner Brandi L, Oden Rosalind P, He Jianping, McCarter Robert
Division of General Pediatrics and Community Health, Children's National Medical Center, Washington, DC, USA.
Center for Translational Science, Children's National Medical Center, Washington, DC, USA.
J Community Health. 2017 Feb;42(1):1-9. doi: 10.1007/s10900-016-0227-1.
Infant-parent bedsharing increases the risk of SIDS and other sleep-related deaths. Despite AAP recommendations to avoid bedsharing, public health efforts have been unsuccessful in changing behaviors. African-American infants are more than twice as likely to die from SIDS and other sleep-related deaths, and are also twice as likely to bedshare with their parents. Further, African-American parents have a high degree of self-efficacy with regards to preventing infant suffocation, but low self-efficacy with regards to SIDS risk reduction. It is unclear whether messages emphasizing suffocation prevention will decrease bedsharing. To evaluate the impact of specific health messages on African-American parental decisions regarding infant sleep location. We conducted a randomized, controlled trial of African-American mothers of infants. The control group received standard messaging emphasizing AAP-recommended safe sleep practices, including avoidance of bedsharing, for the purposes of SIDS risk reduction. The intervention group received enhanced messaging emphasizing safe sleep practices, including avoidance of bedsharing, for both SIDS risk reduction and suffocation prevention. Participants completed interviews at 2-3 weeks, 2-3 months, and 5-6 months after the infant's birth. 1194 mothers were enrolled in the study, and 637 completed all interviews. Bedsharing, both usually (aOR 1.005 [95 % CI 1.003, 1.006]) and last night (aOR 1.004 [95 % CI 1.002, 1.007]) increased slightly but statistically significantly with infant age (p < 0.001). Receipt of the enhanced message did not impact on sleep location. Maternal belief that bedsharing increased the risk of SIDS or suffocation declined over 6 months (p < 0.001) and did not differ by group assignment. African-American mothers who received an enhanced message about SIDS risk reduction and suffocation prevention were no less likely to bedshare with their infants.
Clinical Trials.gov identifier NCT01361880.
婴儿与父母同床睡觉会增加婴儿猝死综合征（SIDS）及其他与睡眠相关死亡的风险。尽管美国儿科学会（AAP）建议避免同床睡觉，但公共卫生方面的努力在改变行为上并未成功。非裔美国婴儿死于SIDS及其他与睡眠相关死亡的可能性是其他婴儿的两倍多，并且与父母同床睡觉的可能性也是其他婴儿的两倍。此外，非裔美国父母在预防婴儿窒息方面自我效能感较高，但在降低SIDS风险方面自我效能感较低。尚不清楚强调预防窒息的信息是否会减少同床睡觉的情况。为了评估特定健康信息对非裔美国父母关于婴儿睡眠地点决策的影响。我们对非裔美国婴儿的母亲进行了一项随机对照试验。对照组收到强调AAP推荐的安全睡眠做法的标准信息，包括为降低SIDS风险而避免同床睡觉。干预组收到强化信息，强调为降低SIDS风险和预防窒息而采取的安全睡眠做法，包括避免同床睡觉。参与者在婴儿出生后的2至3周、2至3个月和5至6个月完成访谈。1194名母亲参与了该研究，637名完成了所有访谈。同床睡觉情况，无论是通常情况（调整后比值比[aOR]为1.005[95%置信区间（CI）为1.003，1.006]）还是昨晚情况（aOR为1.004[95%CI为1.002，1.007]），都随着婴儿年龄的增长而略有增加，但在统计学上具有显著意义（p<0.001）。收到强化信息对睡眠地点没有影响。母亲认为同床睡觉会增加SIDS或窒息风险的信念在6个月内下降（p<0.001），且在不同组间没有差异。收到关于降低SIDS风险和预防窒息强化信息的非裔美国母亲与婴儿同床睡觉的可能性并未降低。
ClinicalTrials.gov标识符NCT01361880
