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SIDS risk factors and factors associated with prone sleeping in Sweden
  1. B Alm1,
  2. P Möllborg2,
  3. L Erdes3,
  4. R Pettersson4,
  5. N Åberg1,
  6. G Norvenius1,
  7. G Wennergren1
  1. 1Department of Paediatrics, Göteborg University, Sweden
  2. 2Central Infant Welfare Bureau, Uddevalla Hospital, Sweden
  3. 3Paediatric Outpatient Clinic, Skene, Sweden
  4. 4Department of Paediatrics, Skaraborg Hospital, Skövde, Sweden
  1. Correspondence to:
    Dr Bernt Alm
    Department of Paediatrics, Göteborg University, The Queen Silvia Children’s Hospital, SE-416 85 Göteborg, Sweden; bernt.alm{at}


Objective: To compare the current prevalence of risk factors for sudden infant death syndrome (SIDS) in Sweden with a decade earlier, and assess factors associated with prone sleeping.

Methods: The results of a cohort study (Infants of Western Sweden) and a population based case-control study (Nordic Epidemiological SIDS Study) were examined. Subjects were 5600 healthy 6 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 5.6% and supine sleeping increased from 35.3% to 47.3%. Side or side/supine sleeping 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 to 4.0), if she was a heavy smoker in the third trimester (OR 44.1, 95% CI 1.6 to 1199.6), and if the child was irritable (OR 2.5, 95% CI 1.3 to 5.1), shared a bedroom with siblings (OR 2.6, 95% CI 1.0 to 6.6), or never used a dummy (OR 3.2, 95% CI 1.9 to 5.4).

Conclusions: Parents have complied with advice to prevent SIDS given at infant welfare centres for the last 10 years. A change in the preferred sleeping position from side variants to exclusively supine, and reducing the number of pregnant women smoking may be beneficial. Use of a prone sleeping position was associated with maternal employment status, maternal smoking, temperament of the child, dummy use, and sharing a bedroom with siblings.

  • epidemiologic factors
  • maternal smoking
  • prone position
  • SIDS incidence
  • sudden infant death syndrome

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  • Published Online First 7 February 2006

  • The Infants of Western Sweden study was supported by the Unit for Research and Development in the Western Sweden Region, the Faculty of Medicine, the Sahlgrenska Academy, Göteborg University, the Committee of Public Health in the Western Sweden Region, the Vårdal Foundation for Health Care Sciences and Allergy Research, and the Research Fund of the Swedish Asthma and Allergy Association

  • Competing interests: None declared.

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