Baddock Sally A, Tipene-Leach David, Williams Sheila M, Tangiora Angeline, Jones Raymond, Iosua Ella, Macleod Emily C, Taylor Barry J
School of Midwifery, Otago Polytechnic, Dunedin, New Zealand;
Departments of Women's and Children's Health, and.
Pediatrics. 2017 Feb;139(2). doi: 10.1542/peds.2016-0162. Epub 2017 Jan 2.
To compare an indigenous sleep device (wahakura) for infants at high risk for sudden unexpected death with a bassinet, for measures of infant sleep position, head covering, breastfeeding, bed-sharing, and maternal sleep and fatigue.
A total of 200 mainly Māori pregnant women were recruited from deprived areas of New Zealand. They were randomized to receive a bassinet or wahakura and asked to sleep the infant in this device from birth. Questionnaires at 1, 3, and 6 months and an overnight infrared video in the home at 1 month were completed.
An intention-to-treat and an "as-used" analysis of questionnaires showed no group differences at 1, 3, and 6 months in infant-adult direct bed-sharing (7% vs 12%, P = .24 at 1 month), and at the 6-month interview, the wahakura group reported twice the level of full breastfeeding (22.5% vs 10.7%, P = .04). Maternal sleep and fatigue were not significantly different between groups. Video identified no increase in head covering, prone/side sleep position, or bed-sharing in the wahakura group, either from intention-to-treat analysis, or when analyzed for actual sleep location.
There were no significant differences in infant risk behaviors in wahakura compared with bassinets and there were other advantages, including an increase in sustained breastfeeding. This suggests wahakura are relatively safe and can be promoted as an alternative to infant-adult bed-sharing. Policies that encourage utilization are likely to be helpful in high-risk populations.
比较一种用于有意外猝死高风险婴儿的本土睡眠设备（瓦哈库拉）与婴儿床，以评估婴儿睡眠姿势、头部覆盖物、母乳喂养、同床睡眠以及母亲睡眠和疲劳情况。
从新西兰贫困地区招募了总共200名主要为毛利族的孕妇。她们被随机分配接受婴儿床或瓦哈库拉，并被要求从婴儿出生起就让其使用该设备睡觉。在婴儿1个月、3个月和6个月时完成问卷调查，并在1个月时进行一次在家中的夜间红外视频拍摄。
对问卷调查的意向性分析和“实际使用”分析表明，在1个月、3个月和6个月时，婴儿与成人直接同床睡眠情况在两组间无差异（1个月时分别为7%和12%，P = 0.24）；在6个月访谈时，瓦哈库拉组纯母乳喂养水平是另一组的两倍（22.5%对10.7%，P = 0.04）。两组间母亲的睡眠和疲劳情况无显著差异。视频分析显示，无论是在意向性分析中，还是针对实际睡眠地点进行分析时，瓦哈库拉组婴儿头部覆盖物增加、俯卧/侧卧睡眠姿势或同床睡眠情况均未增加。
与婴儿床相比，瓦哈库拉在婴儿风险行为方面无显著差异，且还有其他优势，包括持续母乳喂养增加。这表明瓦哈库拉相对安全，可作为婴儿与成人同床睡眠的替代方案进行推广。鼓励使用瓦哈库拉的政策可能对高风险人群有益。
