Association between sudden infant death syndrome and prone sleep position,bed sharing, and sleeping outside an infant crib in Alaska

Objective. To determine the contribution of prone sleeping, bed sharing, an d sleeping outside an infant crib to sudden infant death syndrome (SIDS). Methods. We conducted a retrospective descriptive study of all SIDS cases i n Alaska from January 1, 1992, through December 31, 1997. Reviewed data sou rces included maternal and infant medical records, autopsy reports, birth a nd death certificates, police and state trooper death scene investigations, and occasionally home interviews. Results. The death certificate identified SIDS as a cause of death for 130 infants (cause-specific infant mortality rate: 2.0 per 1000 live births). A mong infants for whom this information was known, 113 (98%) of 115 were fou nd in the prone position, sleeping outside an infant crib, or sleeping with another person. By contrast, 2 (1.7%) were found alone and supine in their crib (1 of whom was found with a blanket wrapped around his face). Of 40 i nfants who slept with a parent at the time of death, only 1 infant who slep t supine with a non-drug-using parent on an adult nonwater mattress was ide ntified. Conclusion. Almost all SIDS deaths in Alaska occurred in association with p rone sleeping, bed sharing, or sleeping outside a crib. In the absence of o ther risk factors, SIDS deaths associated with parental bed sharing were ra re.