Henderson-Smart D J, Ponsonby A L, Murphy E
New South Wales Centre for Perinatal Health Services Research, University of Sydney and Central Sydney Area Health Service, Australia.
J Paediatr Child Health. 1998 Jun;34(3):213-9. doi: 10.1046/j.1440-1754.1998.00225.x.
In March 1997 a multidisciplinary forum was convened by the National SIDS Council of Australia to review recent evidence concerning risk factors of sudden infant death syndrome (SIDS) and to revise and refine the current guidelines for reducing the risk of SIDS. The forum provided an assessment of the evidence for recommendations to reduce the risk of SIDS using an evidence-based process. Strong evidence has now accumulated that the intervention campaigns to reduce prone sleeping during infancy have been followed by SIDS rate declines. Recent data indicate that the supine position is not associated with an increase in significant morbidity outcomes and provides greater protection for SIDS than the side position, which may be unstable. Covering of the baby's head by bedding is strongly related to SIDS. The infant's sleeping environment should be carefully set up to ensure that the baby's head, including the face, cannot be obstructed during sleep. Parental smoking is strongly associated with SIDS. Structural supportive interventions for parental smoking cessation are required. Bedsharing increases the risk of SIDS amongst smokers and the data are currently not sufficient to provide complete reassurance to nonsmoking parents that bedsharing is safe. Infants should be maintained in a comfortable temperature zone. The evidence for a protective effect of breast-feeding is conflicting, so breast-feeding cannot be promoted strongly as reducing the risk of SIDS. Immunisation has not been associated with SIDS. Parents and carers should be aware of the current guidelines. Health professionals should also be aware of the evidence on which the current recommendations are based. Effective health education programmes should lead to a further decline in SIDS mortality in Australia.
1997年3月，澳大利亚国家婴儿猝死综合征理事会召开了一个多学科论坛，以审查有关婴儿猝死综合征（SIDS）风险因素的最新证据，并修订和完善当前降低SIDS风险的指南。该论坛采用循证方法对降低SIDS风险的建议证据进行了评估。现在已有充分证据表明，旨在减少婴儿期俯卧睡眠的干预活动开展之后，SIDS发生率有所下降。最近的数据表明，仰卧位与严重发病结局的增加无关，并且与侧卧位相比，仰卧位对SIDS的保护作用更强，因为侧卧位可能不稳定。床上用品盖住婴儿头部与SIDS密切相关。应仔细设置婴儿的睡眠环境，以确保婴儿的头部，包括面部，在睡眠期间不会被遮挡。父母吸烟与SIDS密切相关。需要采取结构性支持干预措施来帮助父母戒烟。同床睡眠会增加吸烟者中SIDS的风险，目前的数据尚不足以让不吸烟的父母完全放心同床睡眠是安全的。应将婴儿保持在舒适的温度范围内。母乳喂养具有保护作用的证据存在矛盾，因此不能大力提倡母乳喂养来降低SIDS风险。免疫接种与SIDS无关。父母和护理人员应了解当前的指南。卫生专业人员也应了解当前建议所依据的证据。有效的健康教育计划应能使澳大利亚的SIDS死亡率进一步下降。
