A CASE-CONTROL STUDY OF ROUTINE AND DEATH SCENE SLEEP POSITION AND SUDDEN-INFANT-DEATH-SYNDROME IN SOUTHERN CALIFORNIA

Objective.-To investigate whether infants who died of sudden infant de ath syndrome (SIDS) were routinely placed in different sleep positions compared with healthy infants in a multiethnic diverse population in the United States. Design.-A population-based case-control study. Sett ing.-Five counties in Southern California including Los Angeles, Orang e, San Bernardino, Riverside, and San Diego. Participants.-Parents of 200 white, African-American, Hispanic, and Asian infants who died of S IDS between January 1989 and December 1992 and parents of 200 healthy, living infants matched on the basis of birth hospital, birth date, ra ce, and gender. Information was obtained from detailed telephone inter views with the parents and validated with obstetric and pediatric reco rds. Main Outcome Measures.-Routine sleep position, type of bedding, a nd objects in bed were determined for both case and control infants, w hile the last-placed and found sleep and face positions at death were reported for SIDS infants. Results.-Approximately 66% of SIDS infants and 64% of comparison infants routinely slept on their abdomens (P=.91 ). At the time of death, 80% of cases were found sleeping on their abd omens. There was no difference in routine sleep position for SIDS infa nts and comparison infants (odds ratio=0.76; 95% confidence interval, 0.42 to 1.38), while simultaneously adjusting for birth weight (in gra ms), medical conditions at birth, breast-feeding, passive smoking, mat ernal recreational drug use, prenatal care, and infant vomiting. Hispa nic parents routinely placed their infants on their abdomens less freq uently than white parents (P<.01). However, the prone sleep position ( face down) was the most commonly found sleep position at death in both Hispanic and non-Hispanic infants. Conclusions.-Routine prone sleep p osition was not associated with an increased risk of SIDS in this stud y population. The results need to be confirmed with other parents of S IDS infants interviewed before the height of publicity regarding prone sleep position in the United States.