This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (27)  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Hillary Sandra Klonoff-Cohen, PhD; Sharon Leigh Edelstein, ScM

JAMA. 1995;273(10):790-794.

Abstract
Objective.
—To investigate whether infants who died of sudden infant death syndrome (SIDS) were routinely placed in different sleep positions compared with healthy infants in a multiethnic diverse population in the United States.

Design.
—A population-based case-control study.

Setting.
—Five counties in Southern California including Los Angeles, Orange, San Bernardino, Riverside, and San Diego.

Participants.
—Parents of 200 white, African-American, Hispanic, and Asian infants who died of SIDS between January 1989 and December 1992 and parents of 200 healthy, living infants matched on the basis of birth hospital, birth date, race, and gender. Information was obtained from detailed telephone interviews with the parents and validated with obstetric and pediatric records.

Main Outcome Measures.
—Routine sleep position, type of bedding, and objects in bed were determined for both case and control infants, while the last-placed and found sleep and face positions at death were reported for SIDS infants.

Results.
—Approximately 66% of SIDS infants and 64% of comparison infants routinely slept on their abdomens (P=.91). At the time of death, 80% of cases were found sleeping on their abdomens. There was no difference in routine sleep position for SIDS infants and comparison infants (odds ratio=0.76; 95% confidence interval, 0.42 to 1.38), while simultaneously adjusting for birth weight (in grams), medical conditions at birth, breast-feeding, passive smoking, maternal recreational drug use, prenatal care, and infant vomiting. Hispanic parents routinely placed their infants on their abdomens less frequently than white parents (P<.01). However, the prone sleep position (face down) was the most commonly found sleep position at death in both Hispanic and non-Hispanic infants.

Conclusions.
—Routine prone sleep position was not associated with an increased risk of SIDS in this study population. The results need to be confirmed with other parents of SIDS infants interviewed before the height of publicity regarding prone sleep position in the United States.

(JAMA. 1995;273:790-794)

Author Affiliations
From the Department of Family and Preventive Medicine, Division of Epidemiology, University of California, San Diego.

Footnotes
Reprint requests to Department of Family and Preventive Medicine, Division of Epidemiology, 9500 Gilman Dr, 0607, La Jolla, CA 92037-0607 (Dr Klonoff-Cohen).

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

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Impact of Sleep on Arrhythmogenesis
Verrier and Josephson
Circ Arrhythm Electrophysiol 2009;2:450-459.
FULL TEXT  

International Trends in Sudden Infant Death Syndrome: Stabilization of Rates Requires Further Action
Hauck and Tanabe
Pediatrics 2008;122:660-666.
FULL TEXT  

Participation of Next of Kin in Research Following Sudden, Unexpected Death of a Child
Taneja et al.
Arch Pediatr Adolesc Med 2007;161:453-456.
ABSTRACT | FULL TEXT  

Infant sleeping position and the sudden infant death syndrome: systematic review of observational studies and historical review of recommendations from 1940 to 2002
Gilbert et al.
Int J Epidemiol 2005;34:874-887.
ABSTRACT | FULL TEXT  

Outdoor carbon monoxide, nitrogen dioxide, and sudden infant death syndrome
Klonoff-Cohen et al.
Arch. Dis. Child. 2005;90:750-753.
ABSTRACT | FULL TEXT  

Sleep Environment and the Risk of Sudden Infant Death Syndrome in an Urban Population: The Chicago Infant Mortality Study
Hauck et al.
Pediatrics 2003;111:1207-1214.
ABSTRACT | FULL TEXT  

Infant Sleeping Position and the Risk of Sudden Infant Death Syndrome in California, 1997-2000
Li et al.
Am J Epidemiol 2003;157:446-455.
ABSTRACT | FULL TEXT  

The Contribution of Prone Sleeping Position to the Racial Disparity in Sudden Infant Death Syndrome: The Chicago Infant Mortality Study
Hauck et al.
Pediatrics 2002;110:772-780.
ABSTRACT | FULL TEXT  

Maternal and Paternal Recreational Drug Use and Sudden Infant Death Syndrome
Klonoff-Cohen and Lam-Kruglick
Arch Pediatr Adolesc Med 2001;155:765-770.
ABSTRACT | FULL TEXT  

Sudden Infant Death Syndrome, Bedsharing, Parental Weight, and Age at Death
Carroll-Pankhurst and Mortimer Jr
Pediatrics 2001;107:530-536.
ABSTRACT | FULL TEXT  

Sudden Infant Death With External Airways Covered: Case-Comparison Study of 206 Deaths in the United States
Scheers et al.
Arch Pediatr Adolesc Med 1998;152:540-547.
ABSTRACT | FULL TEXT  

Sudden Infant Death Syndrome and Circadian Rhythm
Wehrmacher
JAMA 1995;274:944-944.
ABSTRACT  

Does Avoiding the Prone Position Prevent SIDS?
JWatch Psychiatry 1995;1995:19-19.
FULL TEXT  

DOES AVOIDING THE PRONE POSITION PREVENT SIDS?
JWatch General 1995;1995:6-6.
FULL TEXT  

The Effect of Passive Smoking and Tobacco Exposure Through Breast Milk on Sudden Infant Death Syndrome
Klonoff-Cohen et al.
JAMA 1995;273:795-798.
ABSTRACT  

Sleep Position and Sudden Infant Death Syndrome
Willinger
JAMA 1995;273:818-819.
ABSTRACT