Published online November 1, 2006
PEDIATRICS Vol. 118 No. 5 November 2006, pp. 2051-2059 (doi:10.1542/peds.2006-0176)
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ARTICLE

Sleep Environment, Positional, Lifestyle, and Demographic Characteristics Associated With Bed Sharing in Sudden Infant Death Syndrome Cases: A Population-Based Study

Barbara M. Ostfeld, PhDa, Harold Perl, MDb, Linda Esposito, MPH, PhDa, Katherine Hempstead, PhDc, Robert Hinnen, MSWb, Alissa Sandler, MSW, LCSWb, Paula Goldblatt Pearson, RN, MAb and Thomas Hegyi, MDa

a SIDS Center of New Jersey, Department of Pediatrics, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, New Jersey
b SIDS Center of New Jersey-Joseph M. Sanzari Children's Hospital, Hackensack University Medical Center, Hackensack, New Jersey
c Center for Health Statistics, New Jersey Department of Health and Senior Services, Trenton, New Jersey

BACKGROUND. In 2005, the American Academy of Pediatrics Task Force on Sudden Infant Death Syndrome recommended that infants not bed share during sleep.

OBJECTIVE. Our goal was to characterize the profile of risk factors associated with bed sharing in sudden infant death syndrome cases.

DESIGN/METHODS. We conducted a population-based retrospective review of sudden infant death syndrome cases in New Jersey (1996–2000) dichotomized by bed-sharing status and compared demographic, lifestyle, bedding-environment, and sleep-position status.

RESULTS. Bed-sharing status was reported in 239 of 251 cases, with sharing in 39%. Bed-sharing cases had a higher percentage of bedding risks (44.1% vs 24.7%), exposure to bedding risks in infants discovered prone (57.1% vs 28.2%), and lateral sleep placement (28.9% vs 17.8%). The prone position was more common for bed-sharing and non–bed-sharing cases at placement (45.8% and 51.1%, respectively) and discovery (59.0% and 64.4%, respectively). In multivariable logistic-regression analyses, black race, mother <19 years, gravida >2, and maternal smoking were associated with bed sharing. There was a trend toward less breastfeeding in bed-sharing cases (22% vs 35%). In bed-sharing cases, those breastfed were younger than those who were not and somewhat more exposed to bedding risks (64.7% vs 45.1%) but less likely to be placed prone (11.8% vs 52.9%) or have maternal smoking (33% vs 66%).

CONCLUSIONS. Bed-sharing cases were more likely to have had bedding-environment and sleep-position risks and higher ratios of demographic and lifestyle risk factors. Bed-sharing subjects who breastfed had a risk profile distinct from those who were not breastfed cases. Risk and situational profiles can be used to identify families in greater need of early guidance and to prepare educational content to promote safe sleep.

Key Words: sudden infant death syndrome • bed sharing • maternal smoking

Abbreviations: SIDS—sudden infant death syndrome • SCNJ—SIDS Center of New Jersey • OR—odds ratio • CI—confidence interval • AOR—adjusted odds ratio • AAP—American Academy of Pediatrics

Accepted Jul 18, 2006.




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