SIDS risk factors and factors associated with prone sleeping in Sweden

Bernt Alm ^1*, Per Möllborg ², Laslo Erdes ³, Rolf Pettersson ⁴, Nils Åberg ¹, Gunnar Norvenius ¹ and Göran Wennergren ¹

¹ Dept of Paediatrics, Göteborg University, Sweden
² Central Infant Welfare Bureau, Uddevalla Hospital, Sweden
³ Paediatric Outpatient Clinic, Skene, Sweden
⁴ Dept of Paediatrics, Skaraborg Hospital, Skövde, Sweden

^* To whom correspondence should be addressed. E-mail: bernt.alm{at}medfak.gu.se.

Accepted 22 December 2005

Abstract

Objective: to compare the prevalence of risk factors for SIDS in Sweden today with a decade earlier, and to assess factors associated with prone sleeping. Design: cohort study (Infants of Western Sweden) and population based case-control study (the Nordic SIDS Study).

Subjects: 5600 healthy six-month-old infants born in 2003 in the Western Sweden region and 430 healthy Swedish infants born between 1991 and 1995.

Results: Prone sleeping decreased from 31.8 % to 5.5 % and supine sleeping increased from 35.3 % to 46.2 %. Use of side or side/supine increased from 25.2 % to 43.8 %. Maternal smoking during pregnancy decreased from 23.5 % to 9.5 %. The risk for prone sleeping increased if the mother was unemployed (OR 2.4, 95% CI (1.5, 4.0)), if the mother was a heavy smoker in the third trimester (OR 44.1, 95% CI (1.6, 1199.6), and if the child was irritable (OR 2.5, 95% CI (1.3, 5.1)), shared a bedroom with other children (OR 2.6, 95% CI (1.0, 6.6)) or never used a dummy (OR 3.2, 95% CI (1.9, 5.4)).

Conclusions: Parents have complied with the advice given at the Infant Welfare Centres, which is still effective ten years after the introduction of advice to prevent SIDS. A change of the preferred sleeping position from side variants to exclusively supine, and cessation of smoking among more pregnant women may be beneficial. Use of prone sleeping position was associated with maternal employment status, maternal smoking, temperament of the child, dummy use and sharing the bedroom with siblings.

Keywords: SIDS incidence, epidemiologic factors, maternal smoking, prone position, sudden infant death syndrome

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