Body and head position, covering of the head by bedding and risk of suddeninfant death (SID)

We examined the position of the body and head, and the covering of the head by bedding on discovery in cases of sudden infant death (SID) in Lower Sax ony. Between 1.1.1986 and 31.12.1992 structured, questionnaire-based interv iews were carried out with parents of 140 SID victims. Control data were ta ken from a population-based cross-sectional study on infant sleeping positi on performed by the German Health Office (BGA) in autumn 1991. Of the SID c ases 86.4% were discovered in the prone position [odds ratio (OR) = 7.4, 95 % confidence interval (CI) = 4.3, 12.7] and 41.4% were found with the head covered. These infants were significantly older than those where the head w as uncovered (p < 0.001) and covering of the head showed a significant asso ciation with a risk of SID (OR = 20.8; 95% CI = 11.5-37.6). Of the SID case s 27.9% were discovered in the face-down position. These infants were signi ficantly younger than the infants who were discovered with the head in a si de or supine position (p < 0.001). This study confirms the increased risk o f SID associated with the prone position and suggests that this association could be related to the development of hypoxaemia or hypercapnia. Together with other factors such as heat stress or an infection, hypoxaemia or hype rcapnia could culminate in SID if the arousal from sleep and auto-resuscita tion apparently fails.