Department of Nursing, Inha University, 100 Inha-ro, Michuhol-gu, Incheon, 22212, Republic of Korea.
Division of Forensic Medicine, National Forensic Service, 10, Ipchun-ro, Wonju-si, Gangwon-do, Republic of Korea, 26460.
BMC Pediatr. 2021 Oct 9;21(1):443. doi: 10.1186/s12887-021-02894-8.
Despite the significant reduction decades ago in sudden unexpected death in infancy (SUDI), decline of rates has slowed and stalled in some countries, including the USA. This led to an appreciation of ethnic variations in SUDI rates and the need to increase cultural sensitivity regarding sleep practices and circumstantial factors of SUDI. The study explored SUDI-related factors, in journal articles from two geo-cultural regions (Asian and Western countries), particularly for factors related to infant sleep practices.
A systematic review was conducted to identify SUDI-related factors in articles from PubMed, Scopus, and the Korean Citation Index from January 1992 to April 2019. From each article, SUDI-related factors were retrieved and categorized through the identification, aggregation, and categorization of factors into the areas of the triple risk model (TRM) of SUDI by their meanings and commonality. Significant trends in the frequency of factors were analyzed across time and between the two geo-cultural regions (Asian and Western countries) of article.
From a review of 218 articles (38 Asian and 180 Western articles), 84 SUDI-related factors were identified: 39 factors for TRM 1, 44 factors for TRM 2, and one factor for TRM 3. Four of the top-ranked 10 factors were found in both cultural zones: sleep position, male sex, bed-sharing, and genetics. Both cultural zones identified sleep position (44.0%), bed-sharing (22.0%), and rooming-in (16.5%) as the three most important sleep-related factors for SUDI. Variations between the cultural zones were observed in the place of SUDI occurrence, overheating, swaddling or bedding standards, and smoking.
Regardless of the urgent need to identify SUDI-related factors in low-SUDI societies, Asian cultures showed a significant lack of articles on SUDI. Several sociocultural issues were recognized such as the meaning of bed-sharing and rooming-in, along with residential styles and traditional health beliefs on sleep-related SUDI factors. Particularly little attention towards smoking was found in Asian articles in terms of frequency, suggesting the need to enhance SUDI reduction strategies by incorporating gender-sensitive smoking cessation interventions. This review of SUDI factors requests child health professionals to be alert to sociocultural variations in sleep practices and SUDI factors.
尽管几十年前婴儿猝死综合征（SUDI）的发生率显著下降，但在一些国家（包括美国），这一比率的下降速度已经放缓甚至停滞。这导致人们认识到 SUDI 发生率存在种族差异，需要提高对睡眠习惯和 SUDI 环境因素的文化敏感性。本研究探讨了来自两个地理文化区域（亚洲和西方国家）的期刊文章中的 SUDI 相关因素，特别是与婴儿睡眠习惯相关的因素。
系统检索了 1992 年 1 月至 2019 年 4 月期间 PubMed、Scopus 和韩国引文索引中与 SUDI 相关的文章，从每篇文章中提取 SUDI 相关因素，并通过识别、汇总和分类，根据 SUDI 三重风险模型（TRM）的含义和共性将这些因素归入各个领域。对不同时间段和两个地理文化区域（亚洲和西方国家）的文章中因素的频率进行了显著趋势分析。
从 218 篇文章（38 篇亚洲文章和 180 篇西方文章）的综述中，确定了 84 个与 SUDI 相关的因素：TRM1 有 39 个因素，TRM2 有 44 个因素，TRM3 有 1 个因素。在两个文化区都排名前十的四个最重要的因素中有四个：睡眠姿势、男性、同床共枕和遗传。两个文化区都确定了睡眠姿势（44.0%）、同床共枕（22.0%）和母婴同室（16.5%）是 SUDI 发生的三个最重要的与睡眠相关的因素。文化区之间存在一些差异，包括 SUDI 发生的地点、过热、襁褓或床上用品标准以及吸烟。
尽管在 SUDI 发生率较低的社会中迫切需要确定与 SUDI 相关的因素，但亚洲文化中有关 SUDI 的文章却明显缺乏。研究还发现了一些社会文化问题，如同床共枕和母婴同室的含义，以及住宅风格和传统的与睡眠相关的 SUDI 因素的健康观念。亚洲文章中很少有关于吸烟的频率的关注，这表明需要通过纳入对性别敏感的戒烟干预措施来加强 SUDI 减少策略。对 SUDI 因素的这一综述要求儿童健康专业人员注意睡眠习惯和 SUDI 因素的社会文化差异。
