TABLE 4

Adjusted Associations With Usual Safe Infant Sleep Practices, 29 States, PRAMS, 2016

Usual Safe Infant Sleep Practice
Back Sleep Positiona (n = 30 358)Separate Approved Sleep Surfaceb (n = 29 191)Room-Sharing Without Bed-Sharingc (n = 29 841)No Soft Objects or Loose Beddingd (n = 29 259)
Adjusted PrevalenceaPR (95% CI)Adjusted PrevalenceaPR (95% CI)Adjusted PrevalenceaPR (95% CI)Adjusted PrevalenceaPR (95% CI)
Sociodemographic characteristics
 Maternal age, y
  <2076.00.98 (0.93–1.03)28.30.85 (0.72–1.00)56.20.98 (0.89–1.07)27.30.66 (0.55–0.78)
  20–2474.50.96 (0.93–0.99)27.90.84 (0.77–0.92)53.60.93 (0.89–0.98)36.20.87 (0.80–0.93)
  25–2977.8Reference33.2Reference57.5Reference41.7Reference
  30–3481.71.05 (1.03–1.08)33.71.02 (0.95–1.09)57.20.99 (0.95–1.04)46.31.11 (1.05–1.17)
  ≥3580.71.04 (1.01–1.07)31.80.96 (0.89–1.04)59.31.03 (0.98–1.08)46.91.12 (1.06–1.20)
 Maternal race and ethnicity
  Non-Hispanic white81.5Reference34.0Reference56.4Reference43.2Reference
  Non-Hispanic black67.00.82 (0.79–0.86)28.70.85 (0.77–0.93)52.20.93 (0.87–0.98)42.50.99 (0.92–1.06)
  Hispanic80.00.98 (0.96–1.01)32.10.94 (0.87–1.03)61.81.10 (1.05–1.15)44.51.03 (0.97–1.10)
  Non-Hispanic American Indian or Alaska Native85.31.05 (1.01–1.08)27.10.80 (0.68–0.93)51.50.91 (0.83–1.01)39.20.91 (0.80–1.03)
  Non-Hispanic Asian or Pacific Islander73.60.90 (0.86–0.95)19.70.58 (0.50–0.67)55.20.98 (0.91–1.05)27.10.63 (0.56–0.70)
  Non-Hispanic multiple races79.30.97 (0.92–1.03)26.10.77 (0.62–0.95)56.51.00 (0.90–1.11)41.80.97 (0.84–1.11)
 Maternal education
  Less than high school76.00.92 (0.88–0.95)32.50.94 (0.84–1.05)59.81.11 (1.03–1.19)48.41.00 (0.92–1.09)
  High school diploma or GED77.00.93 (0.90–0.96)30.40.88 (0.80–0.96)60.71.12 (1.06–1.18)36.20.75 (0.69–0.81)
  Some college or associate’s degree76.50.92 (0.90–0.95)29.20.84 (0.78–0.91)56.51.04 (1.00–1.09)36.50.75 (0.71–0.80)
  Bachelor’s degree or higher82.9Reference34.6Reference54.1Reference48.4Reference
 Marital status
  Married79.2Reference33.0Reference57.9Reference43.8Reference
  Unmarried77.80.98 (0.96–1.01)29.90.90 (0.84–0.97)55.20.95 (0.91–0.99)39.70.90 (0.85–0.96)
 Gestational age at delivery, wk
  <3479.21.01 (0.97–1.04)34.51.09 (0.98–1.20)64.71.14 (1.08–1.21)45.71.08 (1.00–1.17)
  34–3677.90.99 (0.96–1.02)33.21.04 (0.95–1.15)59.51.05 (0.99–1.11)42.21.00 (0.93–1.07)
  37+78.6Reference31.8Reference56.6Reference42.3Reference
Behavioral characteristics
 Current breastfeeding
  No79.1Reference36.4Reference59.6Reference41.3Reference
  Yes78.00.99 (0.97–1.01)28.30.78 (0.73–0.82)54.70.92 (0.89–0.95)43.21.05 (1.00–1.10)
 Current maternal smoking
  No78.5Reference32.8Reference57.0Reference43.0Reference
  Yes79.11.01 (0.98–1.04)25.30.77 (0.70–0.86)56.60.99 (0.94–1.05)37.20.87 (0.80–0.94)
Health care characteristics
 WIC participation during pregnancy
  No79.2Reference32.3Reference56.0Reference42.8Reference
  Yes77.70.98 (0.96–1.01)31.30.97 (0.90–1.04)58.71.05 (1.00–1.10)41.50.97 (0.91–1.03)
 Timing of prenatal care initiation
  First trimester78.8Reference32.4Reference56.9Reference42.9Reference
  Late or no prenatal care77.30.98 (0.95–1.01)28.70.89 (0.81–0.97)57.51.01 (0.96–1.07)39.00.91 (0.85–0.98)
 Insurance coverage at delivery
  Private80.0Reference32.8Reference54.5Reference43.4Reference
  Medicaid77.70.97 (0.95–1.00)30.70.94 (0.87–1.01)60.51.11 (1.06–1.16)40.80.94 (0.88–1.00)
  Uninsured72.30.90 (0.84–0.97)30.10.92 (0.76–1.11)55.51.02 (0.91–1.14)42.40.98 (0.84–1.13)
 Received advice to place infant on back to sleep
  No62.6Reference
  Yes79.91.28 (1.21–1.35)
 Received advice to place infant to sleep in a crib, bassinet, or pack and play
  No27.0Reference
  Yes32.91.22 (1.12–1.32)
 Received advice to place infant’s crib or bed in mother’s room
  No53.8Reference
  Yes60.31.12 (1.09–1.16)
 Received advice on what should and should not go in bed with infants
  No37.3Reference
  Yes43.31.16 (1.08–1.24)
  • All models are adjusted for PRAMS state. Data are from Alaska, Arkansas, Colorado, Connecticut, Delaware, Illinois, Iowa, Louisiana, Maine, Maryland, Massachusetts, Michigan, Missouri, Nebraska, New Hampshire, New Jersey, New Mexico, New York, Oklahoma, Pennsylvania, Rhode Island, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, and Wyoming. aPR, adjusted prevalence ratio; CI, confidence interval; GED, general equivalency diploma; —, not applicable.

  • a Defined as most often placing their infant to sleep on the back versus side, stomach, or combination.

  • b Defined as a composite of 5 items indicating how the infant usually slept in the past 2 wk: (1) alone in their own crib or bed (always or often versus sometimes, rarely, or never); (2) in a crib, bassinet, or pack and play; (3) not in a standard bed; (4) not on a couch or armchair; and (5) not in car seat or swing (yes versus no).

  • c Defined as a composite of 2 items indicating that the infant usually slept in the past 2 wk: (1) alone in their own crib or bed (always or often versus sometimes, rarely, or never) and (2) in the same room as their mothers (yes versus no).

  • c Defined as a composite of 3 items indicating that the infant usually slept in the past 2 wk without (1) blankets; (2) toys, cushions, or pillows; and (3) crib bumper pads (yes versus no).