A recent analysis found that the significant decline in sudden infant death syndrome is not just the result changes in recommended sleep position and environment, but of a combination of factors including improved prenatal and neonatal care, decreased maternal smoking, increased breastfeeding rates and declines in teen pregnancy.
“It is true without any qualification that it is safest for babies to sleep on their backs. This study and others have shown it. This study raises the question of other factors being critical in declining SIDS rates, not just sleep environment. Efforts to understand the biologic vulnerabilities of these infants are important,” Richard Goldstein, MD, pediatric advanced care team, Boston Children’s Hospital and Dana-Farber Cancer Institute, said in a press release.
Goldstein and colleagues analyzed data from the U.S. Mortality Multiple Causes Records from 1983 to 2012 to assess changes in SIDS rates and potential factors related to the reduction in SIDS.
The overall rate of SIDS postnatal mortality declined by 71.3% over the 30-year analysis, according to the researchers.
A significant decrease in SIDS rates was seen between 1994 and 1996, coinciding with the introduction of the Back-to-Sleep initiative, which encouraged infants sleep on their back and highlighted the need for their sleep environments be hazard free. During this time period, the number of infants sleeping in a prone position dropped from 70% to 24%, and the rate of SIDS declined by 33.5%.
Declines in the rate of SIDS were also attributed to the syndrome’s inclusion in the International Classification of Diseases in 1973, as well as changes in diagnostic practices, according to the researchers.
Goldstein and colleagues noted that pediatricians should be vigilant in advising parents on the safest sleep positions for infants, the dangers of maternal smoking during pregnancy and the benefits of breastfeeding.
“The decline in SIDS deaths follows decreases in infant deaths from known causes. This suggests that broad trends in the health of pregnant women and babies influence infant mortality across the board. While we continue to stress safe sleep environments, we should also move forward in improving overall maternal and infant health and in researching the underlying biology that may well also influence SIDS,” Goldstein said in the release. – by Casey Hower
Disclosures: The researchers report no relevant financial disclosures.