Departments of Pediatrics and
Family Medicine, University of Virginia, Charlottesville, Virginia.
Pediatrics. 2020 Mar;145(3). doi: 10.1542/peds.2019-1523. Epub 2020 Feb 7.
To assess the prevalence of and factors associated with actual recent practice and near-future intention for infant sleep location in a national sample.
There were 3260 mothers from 32 US hospitals who responded to a survey at infant age 2 to 6 months regarding care practices, including usual and all infant sleep locations in the previous 2 weeks and intended location for the next 2 weeks. Mothers were categorized as (1) having practiced and/or intending to practice exclusive room-sharing without bed-sharing, (2) having practiced anything other than exclusive room-sharing but intending to practice exclusive room-sharing, (3) intending to have the infant sleep in another room; and (4) intending to practice bed-sharing all night or part of the night. Multivariable multinomial logistic regression examined associations between sleep-location category, demographics, feeding method, doctor advice, and theory of planned behavior domains (attitudes, social norms, and perceived control).
Fewer than half (45.4%) of the mothers practiced and also intended to practice room-sharing without bed-sharing, and 24.2% intended to practice some bed-sharing. Factors associated with intended bed-sharing included African American race and exclusive breastfeeding; however, the highest likelihood of bed-sharing intent was associated with perceived social norms favoring bed-sharing (adjusted odds ratio [aOR] 5.84; 95% confidence interval [CI] 4.14-8.22) and positive attitudes toward bed-sharing (aOR 190.1; 95% CI 62.4-579.0). Women with a doctor's advice to room-share without bed-sharing intended to practice bed-sharing less (aOR 0.56; 95% CI 0.36-0.85).
Sleep-location practices do not always align with the recommendation to room-share without bed-sharing, and intention does not always correspond with previous practice. Attitudes, perceived social norms, and doctor advice are factors that are amenable to change and should be considered in educational interventions.
在全国样本中评估婴儿睡眠位置的实际近期实践和近期意向的流行率和相关因素。
32 家美国医院的 3260 位母亲在婴儿 2 至 6 个月大时对护理实践进行了调查，包括过去 2 周内通常和所有婴儿的睡眠地点以及未来 2 周内的预期地点。母亲分为以下几类：(1)实行并/或打算实行不与床共享的独睡房间，(2)实行非独睡房间但打算实行独睡房间，(3)打算让婴儿睡在另一个房间；(4)打算整夜或部分时间与床共享。多变量多项逻辑回归分析了睡眠位置类别、人口统计学特征、喂养方式、医生建议和计划行为理论领域（态度、社会规范和感知控制）之间的关联。
不到一半（45.4%）的母亲实行并打算实行无床共享的独睡房间，24.2%的母亲打算实行某种程度的床共享。与打算床共享相关的因素包括非裔美国种族和纯母乳喂养；然而，最有可能的床共享意向与有利于床共享的感知社会规范（调整后的优势比[aOR]5.84；95%置信区间[CI]4.14-8.22）和对床共享的积极态度（aOR 190.1；95%CI 62.4-579.0）相关。有医生建议不与床共享的房间共享的女性打算实行床共享的可能性较低（aOR 0.56；95%CI 0.36-0.85）。
睡眠位置的实践并不总是与不与床共享的房间共享建议一致，意向并不总是与以前的实践相对应。态度、感知社会规范和医生建议是可以改变的因素，应在教育干预中考虑。
