Maternal and Infant Characteristics Associated with Prone and Lateral Infant Sleep Positioning in Washington State, 1996-2002

Received 4 September 2007; received in revised form 28 November 2007; accepted 6 February 2008. published online 31 March 2008.

Objective

To identify factors predictive of either lateral or prone infant sleep positioning.

Study design

We used data for 11340 mother-infant pairs from the Pregnancy Risk Assessment Monitoring System for infants born in Washington State, 1996 to 2002. We used predictive modeling to identify statistically significant (P < .05) predictors of lateral and prone sleep positioning.

Results

Factors associated with both high-risk sleep positions included infant's year of birth, maternal race and ethnicity, maternal county of residence, and maternal parity. Mother's being US-born (versus foreign-born) and male infant sex were predictive only of prone sleep positioning. Having Medicaid as primary insurance, receipt of government benefits, low infant gestational age, and low birth weight were predictive only of lateral sleep positioning.

Conclusions

Factors predictive of either high-risk sleep position should be considered when devising public health intervention strategies for the prevention of SIDS.

Abbreviations: AAP, American Academy of Pediatrics, AUC, Area under the curve, PRAMS, Pregnancy Risk Assessment Monitoring System, SIDS, Sudden infant death syndrome, WIC, Women, Infants, and Children

a Dallas Regional Campus, University of Texas Houston School of Public Health, Houston, TX

b Department of Epidemiology, University of Washington, Seattle, WA

c Department of Pediatrics, University of Washington, Seattle, WA

d Department of Biostatistics, University of Washington, Seattle, WA

e Children's Craniofacial Center, Children's Hospital and Regional Medical Center, Seattle, WA.

Reprint requests: Dr. Christy M. McKinney, University of Texas Houston School of Public Health, Dallas Regional Campus, 6011 Harry Hines Boulevard, V8.110, Dallas, TX 75390.

Supported by NIH/NIDCR Public Health and Behavior Research Training grant T32 DE07132, NIH/NIDCR, and the Comprehensive Oral Health Research Center of Discovery, P60 DE13061 (C.M.); Jean Renny Endowment for Craniofacial Medicine (M.C.); and Children's Hospital and Regional Medical Center Young Investigator Award (J.S.). PRAMS data were made available in part through grant U50/CCU01348404 received by the State of Washington from the Centers for Disease Control and Prevention.

PII: S0022-3476(08)00099-1

doi:10.1016/j.jpeds.2008.02.005

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