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Affiliation
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Department of Pediatrics, Children's Mercy Hospital, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri jdcolvin@cmh.edu. |
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Abstract
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BACKGROUND AND OBJECTIVE: Multiple environmental risk factors are associated with sleep-related infant deaths. Little is known about differences in risk factors for deaths occurring in-home and out-of-home. We sought to compare risk factors for in-home and out-of-home infant deaths.
METHODS: We conducted a cross-sectional analysis of sleep-related infant deaths from 2004 to 2014 in the National Child Fatality Review and Prevention database. The main exposure was setting (in-home versus out-of-home) at time of death. Primary outcomes were known risk factors: sleep position, sleep location (eg, crib), objects in the environment, and bed sharing. Risk factors for in-home versus out-of-home deaths were compared using the χ(2) test and multivariate logistic regressions.
RESULTS: A total of 11 717 deaths were analyzed. Infants who died out-of-home were more likely to be in a stroller/car seat (adjusted odds ratio, 2.6; 95% confidence interval, 2.1-3.4; P <.001) and other locations (adjusted odds ratio, 1.9; 95% confidence interval, 1.5-2.3; P <.001), and placed prone (adjusted odds ratio, 1.1; 95% confidence interval, 1.02-1.27; P =.02). Bed sharing was less common out-of-home (adjusted odds ratio, 0.7; 95% confidence interval, 0.6-0.7; P <.001). There were no differences in sleeping in an adult bed/on person, on a couch/ chair, or objects in the sleep environment.
CONCLUSIONS: Sleep-related infant deaths in the out-of-home setting have higher odds of having certain risk factors, such as prone placement for sleep and location in a stroller/car seat, rather than in a crib/bassinet. Caregivers should be educated on the importance of placing infants to sleep supine in cribs/bassinets to protect against sleep-related deaths, both in and out of the home.
Copyright © 2016 by the American Academy of Pediatrics.
Language: en |