Arnestad M, Andersen M, Rognum T O
Institute of Forensic Medicine, National Hospital of Norway, University of Oslo.
Eur J Pediatr. 1997 Dec;156(12):968-70. doi: 10.1007/s004310050753.
The study was undertaken to test the significance of dummy use and carry-cots for counts of sudden infant death (SID). Based on the impression that very few SID victims have a dummy (comforter, pacifier) in their mouth at the time of death, and that a high proportion of SID babies were found dead in a carry-cot (portable crib, pram), a case-control study was performed. Questionnaires were sent to 167 parents of SID victims and to 352 parents of live-infants matched for sex and time of birth. Questionnaires were returned by 121 parents of SID victims (73%) and 307 parents of controls (87%). Only 4 SID victims (3%) were found dead with a dummy in their mouth. A quarter of the controls always used a dummy, 24% during night-time and 23% during daytime between 0 and 2 months of age, whereas this was only true for 10% in the SID group, the odds ratios being 0.27 for night-time and 0.36 for daytime. This trend was also seen until 1 year of life. Of the SID victims, 48% were found dead in a carry-cot, 79% during the cold time of the year and two thirds outdoors. Most deaths occurred during the afternoon (12 pm-5 pm). In both SID and control groups daytime use of carry-cots was equally frequent. Approximately 40% in both groups slept in such a cot between 5-7 days a week during the daytime.
The use of dummy could be a favourable factor in the prevention of SID. Because of the frequent use of carry-cots during the daytime both in the SID group and the control group, the high percentage of SID in such cots does not seem to be of significance. However the high frequency of deaths in outdoor placed carry-cots during the cold period of the year may give clues to understanding the death mechanism in SID.
本研究旨在检验使用安抚奶嘴和便携婴儿床对婴儿猝死（SID）计数的意义。基于这样一种印象，即很少有婴儿猝死受害者在死亡时口中含着安抚奶嘴（安慰物、橡皮奶头），而且发现高比例的婴儿猝死婴儿是在便携婴儿床（便携式婴儿床、婴儿车）中死亡的，因此进行了一项病例对照研究。向167名婴儿猝死受害者的父母以及352名性别和出生时间匹配的活产婴儿的父母发送了问卷。121名婴儿猝死受害者的父母（73%）和307名对照组父母（87%）回复了问卷。仅4名婴儿猝死受害者（3%）被发现死亡时口中含着安抚奶嘴。四分之一的对照组婴儿一直使用安抚奶嘴，在0至2个月大时，24%在夜间使用，23%在白天使用，而在婴儿猝死组中这一比例仅为10%，夜间的优势比为0.27，白天为0.36。这种趋势在1岁之前也可见。在婴儿猝死受害者中，48%被发现死于便携婴儿床中，79%在一年中的寒冷时期死亡，三分之二在户外。大多数死亡发生在下午（中午12点至下午5点）。在婴儿猝死组和对照组中，白天使用便携婴儿床的频率相同。两组中约40%的婴儿在白天每周有5至7天睡在这样的婴儿床中。
使用安抚奶嘴可能是预防婴儿猝死的一个有利因素。由于婴儿猝死组和对照组在白天都频繁使用便携婴儿床，因此在这种婴儿床中婴儿猝死的高比例似乎并无意义。然而，在一年中的寒冷时期户外放置的便携婴儿床中死亡频率较高，这可能为理解婴儿猝死的死亡机制提供线索。
