Abstract
This paper examines racial differences in trends and predictors of prone and lateral infant sleep positioning among South Carolina mothers and infants. Pregnancy Risk Assessment Monitoring System data were used to analyze linear trends in prone, lateral, and supine infant sleep positioning among 14,648 mother-infant pairs from 1996 to 2007. Logistic regression models were used to examine the predictors of prone and lateral positioning among 9,015 mother-infant pairs from 2000 to 2007. From 1996 to 2007, white infants experienced a reduction in both prone and lateral positioning and an increase in supine positioning (28.2–66.7%), while black infants had smaller decreases in prone and lateral positioning and a smaller increase in supine positioning (22.6–47.1%) than white infants. Compared to births in 2000–2005, births after the explicit recommendation that infants not be placed in the lateral sleep position (2006–2007) were associated with decreased odds of lateral positioning among white infants (odds ratio [OR]: 0.66; 95% confidence interval [CI]: 0.51, 0.87) but not among black infants. The significant predictors of white infants being placed in the prone position were different from the predictors for black infants. Additionally, with regard to lateral sleep positioning, more significant predictors were observed among white infants than black infants. These findings suggest that efforts are warranted to increase the prevalence of supine sleep positioning, especially among black infants. Race-specific programs may efficiently reduce non-supine sleep positioning to help narrow racial gaps in sudden infant death syndrome.
Similar content being viewed by others
References
Hoyert, D. L., Kung, H. C., & Smith, B. L. (2005). Deaths: Preliminary data for 2003. National Vital Statistics, 53(15), 1–48.
Mathews, T. J., & MacDorman, M. F. (2008). Infant mortality statistics from the 2005 period linked birth/infant death data set. National Vital Statistics, 57(2), 1–32.
Dwyer, T., Ponsonby, A. L., Newman, N. M., & Gibbons, L. E. (1991). Prospective cohort study of prone sleeping position and sudden infant death syndrome. Lancet, 337(8752), 1244–1247.
Li, D. K., Petitti, D. B., Willinger, M., McMahon, R., Odouli, R., Vu, H., et al. (2003). Infant sleeping position and the risk of sudden infant death syndrome in California, 1997–2000. American Journal of Epidemiology, 157(5), 446–455.
Ponsonby, A. L., Dwyer, T., Gibbons, L. E., Cochrane, J. A., & Wang, Y. G. (1993). Factors potentiating the risk of sudden infant death syndrome associated with the prone position. New England Journal of Medicine, 329(6), 377–382.
Taylor, J. A., Krieger, J. W., Reay, D. T., Davis, R. L., Harruff, R., & Cheney, L. K. (1996). Prone sleep position and the sudden infant death syndrome in King County, Washington: A case-control study. Journal of Pediatrics, 128(5 Pt 1), 626–630.
American Academy of Pediatrics. (2000). Task force on infant sleep position and sudden infant death syndrome. Changing concepts of sudden infant death syndrome: Implications for infant sleeping environment and sleep position. Pediatrics, 105(3 Pt 1), 650–656.
Kattwinkel, J., Brooks, J., & Myerberg, D. (1992). American academy of pediatrics AAP task force on infant positioning and SIDS: Positioning and SIDS. Pediatrics, 89(6 Pt 1), 1120–1126.
Oyen, N., Markestad, T., Skaerven, R., Irgens, L. M., Helweg-Larsen, K., Alm, B., et al. (1997). Combined effects of sleeping position and prenatal risk factors in sudden infant death syndrome: The Nordic Epidemiological SIDS Study. Pediatrics, 100(4), 613–621.
Fleming, P. J., Blair, P. S., Bacon, C., Bensley, D., Smith, I., Taylor, E., et al. (1996). Environment of infants during sleep and risk of the sudden infant death syndrome: Results of 1993–5 case-control study for confidential inquiry into stillbirths and deaths in infancy. Confidential Enquiry into Stillbirths and Deaths Regional Coordinators and Researchers. BMJ, 313(7051), 191–195.
Hauck, F. R., Moore, C. M., Herman, S. M., Donovan, M., Kalelkar, M., Christoffel, K. K., et al. (2002). The contribution of prone sleeping position to the racial disparity in sudden infant death syndrome: The Chicago Infant Mortality Study. Pediatrics, 110(4), 772–780.
Mitchell, E. A., Tuohy, P. G., Brunt, J. M., Thompson, J. M., Clements, M. S., Stewart, A. W., et al. (1997). Risk factors for sudden infant death syndrome following the prevention campaign in New Zealand: A prospective study. Pediatrics, 100(5), 835–840.
American Academy of Pediatrics. (2005). 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, 116(5), 1245–1255.
McKinney, C. M., Holt, V. L., Cunningham, M. L., Leroux, B. G., & Starr, J. R. (2008). Maternal and infant characteristics associated with prone and lateral infant sleep positioning in Washington state, 1996–2002. Journal of Pediatrics, 153(2), 194–198. 198 e1-3.
Pollack, H. A., & Frohna, J. G. (2002). Infant sleep placement after the back to sleep campaign. Pediatrics, 109(4), 608–614.
Willinger, M., Ko, C. W., Hoffman, H. J., Kessler, R. C., & Corwin, M. J. (2000). Factors associated with caregivers’ choice of infant sleep position, 1994–1998: The National Infant Sleep Position Study. JAMA, 283(16), 2135–2142.
Saraiya, M., Serbanescu, F., Rochat, R., Berg, C. J., Iyasu, S., & Gargiullo, P. M. (1998). Trends and predictors of infant sleep positions in Georgia, 1990 to 1995. Pediatrics, 102(3), E33.
Colson, E. R., Rybin, D., Smith, L. A., Colton, T., Lister, G., & Corwin, M. J. (2009). Trends and factors associated with infant sleeping position: The national infant sleep position study, 1993–2007. Archives of Pediatrics and Adolescent Medicine, 163(12), 1122–1128.
United States Department of Health and Human Services (US DHHS), Centers of Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), Office of Analysis and Epidemiology (OAE), Division of Vital Statistics (DVS). Linked Birth/Infant Death Records 2003–2005 on CDC WONDER On-line database. In; 2003–2005.
The American Community—Blacks: 2004: United States Census Bureau; 2007 February 2007.
Alvarez, A, Stampfel, C, Austin, K, Chapman, D, & McGehee, M. (2009). Racial/ethnic differences in factors associated with infant sleep position: Arkansas, 2000–2005. Little Rock, AR: Arkansas Department of Health; 2009 January 2009.
Shulman, H. B., Gilbert, B. C., Msphbrenda, C. G., & Lansky, A. (2006). The Pregnancy Risk Assessment Monitoring System (PRAMS): Current methods and evaluation of 2001 response rates. Public Health Reports, 121(1), 74–83.
Colson, E. R., Levenson, S., Rybin, D., Calianos, C., Margolis, A., Colton, T., et al. (2006). Barriers to following the supine sleep recommendation among mothers at four centers for the Women, Infants, and Children Program. Pediatrics, 118(2), e243–e250.
Moon, R. Y., & Omron, R. (2002). Determinants of infant sleep position in an urban population. Clinical Pediatrics (Philadelphia), 41(8), 569–573.
Patrick, P., Lincoln, A., Lorenz, D., DeVault, M., & Dooley, S. (2008). Infant sleep position in Oklahoma: Evidence from PRAMS. The Journal of the Oklahoma State Medical Association, 101(8), 182–187.
United States Department of Health and Human Services Assistant Secretary for Planning and Evaluation. Prior HHS poverty guidelines and federal register references. In.
South Carolina Department of Health and Environmental Control (SC DHEC). South Carolina Community Assessment Network (SCAN) On-line Database. Infant Mortality Module. In: South Carolina Department of Health and Environmental Control; 2000–2007.
Malloy, M. H., & Eschbach, K. (2007). Association of poverty with sudden infant death syndrome in metropolitan counties of the United States in the years 1990 and 2000. Southern Medical Journal, 100(11), 1107–1113.
Pickett, K. E., Luo, Y., & Lauderdale, D. S. (2005). Widening social inequalities in risk for sudden infant death syndrome. American Journal of Public Health, 95(11), 1976–1981.
Brenner, R. A., Simons-Morton, B. G., Bhaskar, B., Mehta, N., Melnick, V. L., Revenis, M., et al. (1998). Prevalence and predictors of the prone sleep position among inner-city infants. JAMA, 280(4), 341–346.
Vernacchio, L., Corwin, M. J., Lesko, S. M., Vezina, R. M., Hunt, C. E., Hoffman, H. J., et al. (2003). Sleep position of low birth weight infants. Pediatrics, 111(3), 633–640.
Smith, M. G., Wilkerson, K. L., & Helms, K. H. (2009). South Carolina PRAMS 2007 databook. Columbia, SC: South Carolina Department of Health and Environmental Control.
2008 KIDS COUNT Data Book. Baltimore, MD: Annie E. Casey Foundation; 2008.
Baddock, S. A., Galland, B. C., Bolton, D. P., Williams, S. M., & Taylor, B. J. (2006). Differences in infant and parent behaviors during routine bed sharing compared with cot sleeping in the home setting. Pediatrics, 117(5), 1599–1607.
Lahr, M. B., Rosenberg, K. D., & Lapidus, J. A. (2005). Health departments do it better: Prenatal care site and prone infant sleep position. Maternal and Child Health Journal, 9(2), 165–172.
Acknowledgments
Funding for the South Carolina PRAMS Program is provided by the Center for Disease Control and Prevention, Atlanta, GA (Grant No. 5UR6 DP000502-04) and CDC PRAMS staff assisted in the collection and preparation of this data. We thank Kenneth D. Rosenberg, MD, MPH for his thoughtful review of the manuscript.
Author information
Authors and Affiliations
Corresponding author
Appendix
Appendix
See Table 5.
Rights and permissions
About this article
Cite this article
Smith, M.G., Liu, JH., Helms, K.H. et al. Racial Differences in Trends and Predictors of Infant Sleep Positioning in South Carolina, 1996–2007. Matern Child Health J 16, 72–82 (2012). https://doi.org/10.1007/s10995-010-0718-0
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10995-010-0718-0