Willinger M, Hoffman H J, Hartford R B
Pregnancy and Perinatology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Rockville, MD 20852.
Pediatrics. 1994 May;93(5):814-9.
To evaluate the current knowledge on the relationship between infant sleep position and sudden infant death syndrome (SIDS), and to determine how the information can be used to guide further activities in the United States.
Data from international vital statistics, epidemiologic studies of SIDS risk factors, and studies of outcomes of public health interventions that advocated nonprone sleeping to reduce the risk for SIDS were discussed at a meeting held by the National Institute of Child Health and Human Development (NICHD) with cosponsorship from the National Institute on Deafness and Other Communication Disorders (NIDCD), and the National Center for Health Statistics (NCHS) on January 13, and 14, 1994.
Trends in postneonatal mortality and SIDS rates from 1980 through 1992 were evaluated for Australia, Britain, New Zealand, the Netherlands, Norway, Sweden, and the United States. All of the countries that experienced a rapid decline in prone sleeping also had reductions of approximately 50% in their SIDS rates. Postneonatal mortality rates dropped as well, with the reduction in SIDS being the primary contributor to the reported declines. The major behavioral change in all targeted populations was in sleep position. No significant changes were observed in the proportion of parents who smoked cigarettes, or in breast-feeding. Preliminary data from population-based studies showed there were no reported adverse outcomes associated with a change to side or back sleep position, such as an increase in deaths due to aspiration or in apparent life-threatening events.
The overwhelming opinion of the assembled experts was that the evidence justified greater effort to reach parents with the American Academy of Pediatrics' recommendation that healthy infants, when being put down to sleep, be positioned on their side or back.
评估关于婴儿睡眠姿势与婴儿猝死综合征（SIDS）之间关系的现有知识，并确定如何利用这些信息来指导美国的进一步行动。
1994年1月13日和14日，美国国立儿童健康与人类发展研究所（NICHD）联合美国国立耳聋及其他交流障碍研究所（NIDCD）和国家卫生统计中心（NCHS）召开了一次会议，会上讨论了来自国际生命统计数据、SIDS危险因素的流行病学研究，以及倡导非俯卧睡眠以降低SIDS风险的公共卫生干预措施结果的研究。
评估了1980年至1992年澳大利亚、英国、新西兰、荷兰、挪威、瑞典和美国的新生儿后期死亡率和SIDS发生率趋势。所有俯卧睡眠率迅速下降的国家，其SIDS发生率也下降了约50%。新生儿后期死亡率也有所下降，SIDS发生率的降低是报告下降的主要原因。所有目标人群的主要行为变化是睡眠姿势。吸烟父母的比例或母乳喂养情况未观察到显著变化。基于人群的研究初步数据显示，没有报告与改为侧卧或仰卧睡眠姿势相关的不良后果，如因误吸导致的死亡增加或明显的危及生命事件增加。
与会专家的压倒性意见是，现有证据表明应加大力度，让家长了解美国儿科学会的建议，即健康婴儿睡觉时应侧卧或仰卧。
