Department of Pediatrics, Nemours Children's Health, Delaware, Wilmington, Delaware.
Nemours Biomedical Research, Wilmington, Delaware.
Pediatrics. 2024 Dec 1;154(6). doi: 10.1542/peds.2024-067372.
Maternal substance use during pregnancy heightens risk of sudden unexpected infant death (SUID), including through unsafe sleep practices. Families impacted by substance use frequently experience disproportionate social drivers of poor health and family vulnerability likely contributory to fatality risk. Characteristics of sleep-related SUID among infants born prenatally substance exposed versus nonexposed were compared to identify targeted prevention opportunities.
Using the Sudden Death in the Young Registry, we examined SUID with sleep-related death between 2015 and 2020 across infants prenatally exposed versus nonexposed. Distribution of sleep environment characteristics, social drivers of poor health, and family vulnerability factors were examined using descriptive statistics and χ2.
Of 2010 infants who experienced sleep-related deaths, 283 (14%) were prenatally exposed. More than half of deaths involved an adult bed (52%, n = 1045) or surface sharing with an adult (53%, n = 1074). Supervisors of prenatally exposed infants were disproportionately impaired at infant death versus nonexposed (34%, n = 97 vs 16%, n = 279). Statistically significant associations between prenatal exposure history and vulnerability factors (insurance, child welfare involvement, intimate partner violence, health care barriers) were identified (P < .05).
Sleep-related SUID across infants prenatally exposed versus nonexposed differ in sleep environment characteristics and contributory social vulnerability. Disproportionate sleep environment hazards (surface sharing, supervisor impairment) are identified among prenatally exposed infants that should compel targeted prevention efforts, including safe sleep messaging, discouraging surface sharing, and engaging support persons during impairment periods. Addressing social needs and family vulnerability are also paramount to increase access to health care, safe sleep education, and material resource provision.
孕妇在怀孕期间使用物质会增加婴儿突然意外死亡（SUID）的风险，包括不安全的睡眠习惯。受物质使用影响的家庭经常经历不成比例的健康和家庭脆弱性的社会驱动因素，这可能导致死亡风险增加。本研究比较了产前暴露于物质与未暴露于物质的婴儿与睡眠相关的 SUID 的特征，以确定有针对性的预防机会。
使用年轻突发死亡登记处，我们检查了 2015 年至 2020 年间与睡眠相关的 SUID 中，产前暴露于物质与未暴露于物质的婴儿。使用描述性统计和 χ2 检查睡眠环境特征、健康不良的社会驱动因素和家庭脆弱性因素的分布。
在 2010 名经历睡眠相关死亡的婴儿中，有 283 名（14%）产前暴露。超过一半的死亡涉及成人床（52%，n=1045）或与成人共用表面（53%，n=1074）。与未暴露于物质的婴儿相比，产前暴露的婴儿的监护人在婴儿死亡方面存在不成比例的障碍（34%，n=97 与 16%，n=279）。还确定了产前暴露史与脆弱性因素（保险、儿童福利介入、亲密伴侣暴力、医疗保健障碍）之间存在统计学显著关联（P<.05）。
与未暴露于物质的婴儿相比，产前暴露的婴儿的睡眠相关 SUID 在睡眠环境特征和促成的社会脆弱性方面存在差异。在产前暴露的婴儿中发现了不成比例的睡眠环境危险（表面共享、监护人障碍），这应该促使采取有针对性的预防措施，包括安全睡眠信息、劝阻表面共享，并在监护人障碍期间提供支持。解决社会需求和家庭脆弱性也至关重要，以增加获得医疗保健、安全睡眠教育和物质资源的机会。
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