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Infant Sleep Position: Associated Maternal and Infant Factors

  • Esther K. Chung
    Correspondence
    Address correspondence to Esther K. Chung, MD, MPH, Jefferson Pediatrics/duPont Children's Health Program, 833 Chestnut Street, Suite 300, Philadelphia, PA 19107
    Affiliations
    From the Division of General Pediatrics (Dr Chung), the Institute for Health Policy Studies (Dr Hung), and the Department of Family and Community Medicine (Ms Marchi and Dr Braveman), University of California at San Francisco, San Francisco, Calif; and the Maternal Child Health Branch, the California Department of Health Services, Sacramento, Calif (Dr Chavez)
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  • Yun-Yi Hung
    Affiliations
    From the Division of General Pediatrics (Dr Chung), the Institute for Health Policy Studies (Dr Hung), and the Department of Family and Community Medicine (Ms Marchi and Dr Braveman), University of California at San Francisco, San Francisco, Calif; and the Maternal Child Health Branch, the California Department of Health Services, Sacramento, Calif (Dr Chavez)
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  • Kristen Marchi
    Affiliations
    From the Division of General Pediatrics (Dr Chung), the Institute for Health Policy Studies (Dr Hung), and the Department of Family and Community Medicine (Ms Marchi and Dr Braveman), University of California at San Francisco, San Francisco, Calif; and the Maternal Child Health Branch, the California Department of Health Services, Sacramento, Calif (Dr Chavez)
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  • Gilberto F. Chavez
    Affiliations
    From the Division of General Pediatrics (Dr Chung), the Institute for Health Policy Studies (Dr Hung), and the Department of Family and Community Medicine (Ms Marchi and Dr Braveman), University of California at San Francisco, San Francisco, Calif; and the Maternal Child Health Branch, the California Department of Health Services, Sacramento, Calif (Dr Chavez)
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  • Paula Braveman
    Affiliations
    From the Division of General Pediatrics (Dr Chung), the Institute for Health Policy Studies (Dr Hung), and the Department of Family and Community Medicine (Ms Marchi and Dr Braveman), University of California at San Francisco, San Francisco, Calif; and the Maternal Child Health Branch, the California Department of Health Services, Sacramento, Calif (Dr Chavez)
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      Objective.—To determine the maternal and infant characteristics associated with the back sleep position for infants to guide efforts to increase its use and reduce the risk of Sudden Infant Death Syndrome.
      Methods.—Cross-sectional survey of 3349 mothers delivering in California, February–May 1999.
      Results.—Fifty-two percent of infants were placed in the back sleep position. Factors associated with a lower likelihood of using the back position included all levels of maternal education less than college (eg, for education eighth grade or less—adjusted odds ratio [OR] 0.59; 95% confidence interval [CI], 0.40–0.86); income at or below federal poverty level (OR, 0.65; 95% CI, 0.47–0.90); multiparity (OR, 0.80; 95% CI, 0.67–0.95); race/ethnicity African American (OR, 0.49; 95% CI, 0.37–0.65) and Asian/Pacific Islander (OR, 0.65; 95% CI, 0.48–0.89); speaking a non-English language (OR, 0.69; 95% CI, 0.55, 0.86); and infant age over 7 months (OR, 0.70, 95% CI, 0.52–0.96). Women in Los Angeles (OR, 0.57; 95% CI, 0.42–0.77) and urban areas other than San Diego (OR, 0.70; 95% CI, 0.53–0.92) were less likely to use the back position than those in San Francisco.
      Conclusions.—Greater efforts are needed to promote the back sleep position among families with mothers who lack education beyond some college; live in poverty; and who are African American, Asian/Pacific Islander, multiparous, or non-English speaking.

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