Prevalence and Determinants of Prone Sleeping Position in Infants: Results from Two Cross-Sectional Studies on Risk Factors for SIDS in Germany

Abstract

The authors investigated whether there was a decline in infants sleeping prone and other modifiable risk factors for sudden infant death syndrome (SIDS) in Germany, where, as in some other countries, no nationwide intervention campaign against the prone sleeping position had been initiated. Data were obtained from parents by mailed questionnaires in two cross-sectional studies in 1991 (n = 3,330) and 1995 (n = 3,124). Prevalence of prone sleeping decreased from 37.6% to 8.7% (p < 0.05) in the German population and from 44.1% to 32.0% (p < 0.05) in the Turkish immigrant population. Parents who laid their infants prone in 1995 were less likely to follow advice from physicians, public media, and other parents (relative risks < 0.5, p < 0.05) and were more likely to have a low educational level, to be <20 years old, to be single parents, to have two or more children, to be raised in West Germany, or to be of Turkish ethnicity. Although the information on prone sleeping being a risk factor for SIDS became known among the population, these data suggest that subgroup-specific public intervention campaigns may be needed to reduce the prevalence of prone sleeping even further in those countries where no nationwide campaign has been initiated.

Modifiable risk factors for SIDS in Germany: Results of GeSID

“…Despite the fact that Germany never had a nationwide “back to sleep” campaign, localized prevention campaigns and news coverage brought the message to large segments of the population. Schlaud reported that the prone sleeping prevalence dropped in Germany from 37.6% in 1991 to 8.7% in 1995 18. In our control population only 4% of control infants were placed prone to sleep.…”

Child care decisions: parental choice or chance?

“…Uptake of immunization may be hampered by lack of reliable transport (Bond et al 1998;Forrest et al 2000), whereas epidemiological studies identify clusters of characteristics associated with parents who take up positive or risky child care practices. Positive practice is associated with older suburban mothers who are well supported, better educated and plan their pregnancies (Edwards et al 1998), whereas younger unmarried mothers, experiencing poverty are strongly affected by their socioeconomic peers (Hoddinott & Pill 1999), fail to take up antenatal advice (Clements et al 1997), tend to smoke (Pesa & Shelton 1999), choose to bottle feed (Haug et al 1998;Matthews et al 1998;McIntyre et al 1999), place their babies in the prone position increasing the risk of cot death (Fleming et al 1990;Lindgren et al 1998;Schlaud et al 1999) and miss vaccinations (Zimmerman et al 1996).…”

The German case–control scene investigation study on SIDS: epidemiological approach and main results

“…This has resulted in a downward trend from about 1.5 cases per 1,000 live births in the late 1980s to 0.4 cases per 1,000 live births in 2005. Over this time, a decline in the prevalence of prone sleeping has also be observed [3,4]. Nevertheless, SIDS remains a major threat, with 482 cases in Germany in 2000 and 298 cases in 2007.…”