ORIGINAL ARTICLE

Factors relating to the infant’s last sleep environment in sudden infant death syndrome in the Republic of Ireland

C McGarvey¹, M McDonnell¹, A Chong², M O’Regan³ and T Matthews²

¹ National Sudden Infant Death Register, Temple Street, Dublin 1, Republic of Ireland
² Department of Paediatrics, University College Dublin, Temple Street, Dublin 1, Republic of Ireland
³ Department of Statistics, Trinity College Dublin, Dublin 2, Republic of Ireland

Correspondence to:
Correspondence to:
Dr C McGarvey
The National Sudden Infant Death Register, George’s Hall, The Children’s Hospital, Temple St, Dublin 1, Republic of Ireland; isidansr{at}tsch.ie

Aim: To identify risk factors for sudden infant death syndrome (SIDS) in the sleeping environment of Irish infants.

Methods: A five year population based case-control study with parental interviews conducted for each case and three controls matched for age, place of birth, and last sleep period. A total of 203 SIDS cases and 622 control infants born 1994–98 were studied.

Results: In a multivariate analysis, co-sleeping significantly increased the risk of SIDS both as a usual practice (adjusted OR 4.31; 95% CI 1.07 to 17.37) and during the last sleep period (adjusted OR 16.47; 95% CI 3.73 to 72.75). The associated risk was dependent on maternal smoking (OR 21.84; 95% CI 2.27 to 209.89), and was not significant for infants who were 20 weeks of age (OR 2.63; 95% CI 0.49 to 70.10) or placed back in their own cot/bed to sleep (OR 1.07; 95% CI 0.21 to 5.41). The use of pillows, duvets, and bedding with tog value 10 were not significant risk factors when adjusted for the effects of confounding variables, including maternal smoking and social disadvantage. However, the prone sleeping position remains a significant SIDS risk factor, and among infants using soothers, the absence of soother use during the last sleep period also significantly increased the SIDS risk (OR 5.83; CI 2.37 to 14.36).

Conclusion: Co-sleeping should be avoided in infants who are <20 weeks of age, or whose mothers smoked during pregnancy. The prone position remains a factor in some SIDS deaths, and the relation between soother use and SIDS is a complex variable requiring further study.

Keywords: sudden infant death syndrome; co-sleeping; bed sharing; last sleep period; soothers

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