Ponsonby A L, Dwyer T, Kasl S V, Couper D, Cochrane J A
Menzies Centre for Population Health Research, Hobart, Tasmania, Australia.
Arch Dis Child. 1995 Mar;72(3):204-8. doi: 10.1136/adc.72.3.204.
Intervention to avoid the prone sleeping position during infancy has occurred in various countries after evidence that it increases the risk of sudden infant death syndrome (SIDS). This study examined cohort data to determine if correlates of the prone position differed by period of birth, before intervention (1 May 1988 to 30 April 1991) compared with after intervention (1 May 1991 to 30 April 1992). The usual prone sleeping position was more closely associated with the following factors after intervention: teenage motherhood, low maternal education, paternal unemployment, unmarried motherhood, non-specialist antenatal care, not reading books to prepare for a baby, poor smoking hygiene, and bottle feeding. For example, the association of usual prone position with being unmarried shown by the odds ratio (95% confidence interval) was 0.54 (0.47 to 0.63) in the period before intervention and 1.92 (1.18 to 3.15) in the period after intervention. The alteration in correlates of the prone position reported here provide an example to support the theoretical concept that well known 'modifiable' risk factors for disease tend to be associated with each other in both populations and individuals. This phenomenon was not evident in the population before intervention, that is, before the prone sleeping position became a well known SIDS risk factor.
在有证据表明婴儿俯卧睡眠姿势会增加婴儿猝死综合征（SIDS）风险后，各国纷纷采取干预措施以避免婴儿期采用俯卧睡眠姿势。本研究检查了队列数据，以确定俯卧姿势的相关因素在出生时期上是否存在差异，即干预前（1988年5月1日至1991年4月30日）与干预后（1991年5月1日至1992年4月30日）进行比较。干预后，通常的俯卧睡眠姿势与以下因素的关联更为密切：少女母亲、母亲教育程度低、父亲失业、未婚母亲、非专科产前护理、未读书为育儿做准备、吸烟习惯不良以及奶瓶喂养。例如，比值比（95%置信区间）显示，通常俯卧姿势与未婚的关联在干预前为0.54（0.47至0.63），在干预后为1.92（1.18至3.15）。此处报告的俯卧姿势相关因素的变化提供了一个例子，以支持这样一种理论概念，即疾病的众所周知的“可改变”风险因素在人群和个体中往往相互关联。这种现象在干预前的人群中并不明显，即在俯卧睡眠姿势成为众所周知的SIDS风险因素之前。
