This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services E-mail this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Web of Science (12) Citing Articles via Google Scholar Google Scholar Articles by Vernacchio, L. Articles by Mitchell, A. A. Search for Related Content PubMed PubMed Citation Articles by Vernacchio, L. Articles by Mitchell, A. A. Related Collections Premature & Newborn Social Bookmarking                         What's this?

PEDIATRICS Vol. 111 No. 3 March 2003, pp. 633-640

Sleep Position of Low Birth Weight Infants

Louis Vernacchio, MD, MSc^*,, Michael J. Corwin, MD^*, Samuel M. Lesko, MD, MPH^*, Richard M. Vezina, MPH^*, Carl E. Hunt, MD, Howard J. Hoffman, MA^||, Marian Willinger, PhD^¶ and Allen A. Mitchell, MD^*

^* Slone Epidemiology Center, Boston University, Boston, Massachusetts
Department of Pediatrics Harvard Medical School, Boston, Massachusetts
Department of Pediatrics, Medical College of Ohio, Toledo, Ohio
^|| National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, Maryland
^¶ National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland

--> Objectives. To describe sleep positions among low birth weight infants, variations in sleep position according to birth weight, and changes in sleep position over time. To analyze risk factors and influences associated with prone sleep.

Design. Prospective cohort study.

Setting. Massachusetts and Ohio, 1995–1998.

Study Participants. Mothers of 907 low birth weight infants.

Results. At 1, 3, and 6 months after hospital discharge, the prevalence of prone sleeping was 15.5%, 26.8%, and 28.3%, respectively. The corresponding rates for supine sleeping were 23.8%, 37.9%, and 50.2% and for side sleeping were 57.3%, 32.4%, and 20.6%. Very low birth weight (VLBW) infants (<1500 g) were most likely to be placed in the prone position. From 1995 through 1998, prone sleeping 1 month after hospital discharge declined among all low birth weight infants from 19.9% to 11.4%; among VLBW infants, the decline in prone sleeping was replaced almost entirely by an increase in side sleeping, whereas in larger low birth weight infants, it was replaced primarily by supine sleeping. Among mothers who placed their infants to sleep in nonprone positions, professional medical advice was cited most frequently as the most influential reason, whereas among mothers of prone-sleeping infants, the infant’s preference was cited most frequently. However, mothers of prone-sleeping VLBW infants also frequently cited the influence of medical professionals and nursery practices as most important in the choice of sleeping position. The factors most strongly associated with prone sleeping were single marital status (odds ratio [OR]: 3.0; 95% confidence interval [CI]: 1.5–6.2), black race (OR: 2.6; 95% CI: 1.5–4.5), birth weight <1500 g (OR: 2.4; 95% CI: 1.3–4.3), and multiparity (OR: 2.1, 95% CI: 1.2–3.5).

Conclusions. Prone sleep decreased among low birth weight infants from 1995 to 1998. However, VLBW infants, who are at very high risk for sudden infant death syndrome, are more likely to sleep prone than larger low birth weight infants.

Key Words: sudden infant death syndrome • low birth weight • sleep

Abbreviations: SIDS, sudden infant death syndrome • AAP, American Academy of Pediatrics • SD, standard deviation • VLBW, very low birth weight • OR, odds ratio • CI, confidence interval

---

Received for publication Feb 27, 2002; Accepted Jul 12, 2002.

CiteULike    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				A. Greenough How has research in the past 5 years changed my clinical practice Arch. Dis. Child. Fetal Neonatal Ed., September 1, 2007; 92(5): F404 - F407. [Abstract] [Full Text] [PDF]

				Z. Kassim, N. Donaldson, B. Khetriwal, H. Rao, K. Sylvester, G. F Rafferty, S. Hannam, and A. Greenough Sleeping position, oxygen saturation and lung volume in convalescent, prematurely born infants Arch. Dis. Child. Fetal Neonatal Ed., September 1, 2007; 92(5): 347 - 350. [Abstract] [Full Text] [PDF]

				B. C. Galland, B. J. Taylor, D. P. G. Bolton, and R. M. Sayers Heart rate variability and cardiac reflexes in small for gestational age infants J Appl Physiol, March 1, 2006; 100(3): 933 - 939. [Abstract] [Full Text] [PDF]

				Task Force on Sudden Infant Death Syndrome The Changing Concept of Sudden Infant Death Syndrome: Diagnostic Coding Shifts, Controversies Regarding the Sleeping Environment, and New Variables to Consider in Reducing Risk Pediatrics, November 1, 2005; 116(5): 1245 - 1255. [Abstract] [Full Text] [PDF]

				R. L. Ariagno and M. Mirmiran Back to Sleep for Preterm Infants to Reduce the Risk of SIDS NeoReviews, November 1, 2003; 4(11): e305 - 307. [Full Text] [PDF]