Sleep-Related Sudden Unexpected Infant Death Among Infants Prenatally Substance Exposed.

IF 6.2 2区医学 Q1 PEDIATRICS Pediatrics Pub Date : 2024-11-19 DOI:10.1542/peds.2024-067372

Stephanie Anne Deutsch, Claire E Loiselle, Jobayer Hossain, Allan De Jong

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Abstract

Background and objectives: Maternal substance use during pregnancy heightens risk of sudden unexpected infant death (SUID), including through unsafe sleep practices. Families impacted by substance use frequently experience disproportionate social drivers of poor health and family vulnerability likely contributory to fatality risk. Characteristics of sleep-related SUID among infants born prenatally substance exposed versus nonexposed were compared to identify targeted prevention opportunities.

Methods: Using the Sudden Death in the Young Registry, we examined SUID with sleep-related death between 2015 and 2020 across infants prenatally exposed versus nonexposed. Distribution of sleep environment characteristics, social drivers of poor health, and family vulnerability factors were examined using descriptive statistics and χ2.

Results: Of 2010 infants who experienced sleep-related deaths, 283 (14%) were prenatally exposed. More than half of deaths involved an adult bed (52%, n = 1045) or surface sharing with an adult (53%, n = 1074). Supervisors of prenatally exposed infants were disproportionately impaired at infant death versus nonexposed (34%, n = 97 vs 16%, n = 279). Statistically significant associations between prenatal exposure history and vulnerability factors (insurance, child welfare involvement, intimate partner violence, health care barriers) were identified (P < .05).

Conclusions: Sleep-related SUID across infants prenatally exposed versus nonexposed differ in sleep environment characteristics and contributory social vulnerability. Disproportionate sleep environment hazards (surface sharing, supervisor impairment) are identified among prenatally exposed infants that should compel targeted prevention efforts, including safe sleep messaging, discouraging surface sharing, and engaging support persons during impairment periods. Addressing social needs and family vulnerability are also paramount to increase access to health care, safe sleep education, and material resource provision.

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产前接触药物的婴儿中与睡眠相关的婴儿意外猝死。

背景和目的：母亲在怀孕期间使用药物会增加婴儿意外猝死（SUID）的风险，包括通过不安全的睡眠方式。受药物使用影响的家庭经常会经历不成比例的健康不良社会驱动因素和家庭脆弱性，这很可能会导致死亡风险。我们比较了产前暴露于药物和未暴露于药物的婴儿中与睡眠有关的 SUID 特征，以确定有针对性的预防机会：我们利用幼儿猝死登记系统，对 2015 年至 2020 年间产前暴露与未暴露的婴儿中与睡眠相关的 SUID 死亡进行了研究。我们使用描述性统计和χ2检验了睡眠环境特征、不良健康状况的社会驱动因素和家庭脆弱性因素的分布情况：在 2010 名与睡眠相关死亡的婴儿中，有 283 名（14%）在产前暴露于睡眠环境。半数以上的死亡涉及成人床（52%，n = 1045）或与成人共用床面（53%，n = 1074）。产前暴露婴儿的监护人与未暴露婴儿相比，在婴儿死亡时受到的损害更大（34%，n = 97 vs 16%，n = 279）。产前暴露史与脆弱性因素（保险、儿童福利参与、亲密伴侣暴力、医疗保健障碍）之间存在统计学意义上的重大关联（P < .05）：产前暴露与非暴露婴儿的睡眠相关 SUID 在睡眠环境特征和社会脆弱性方面存在差异。在产前暴露的婴儿中发现了不成比例的睡眠环境危害（表面共用、主管受损），这些危害应迫使我们采取有针对性的预防措施，包括安全睡眠信息、阻止表面共用以及在受损期间让辅助人员参与进来。解决社会需求和家庭脆弱性问题对于增加获得医疗保健、安全睡眠教育和物质资源的机会也至关重要。

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来源期刊

Pediatrics 医学-小儿科

CiteScore

12.80

自引率

5.00%

发文量

791

审稿时长

2-3 weeks

期刊介绍： The Pediatrics® journal is the official flagship journal of the American Academy of Pediatrics (AAP). It is widely cited in the field of pediatric medicine and is recognized as the leading journal in the field. The journal publishes original research and evidence-based articles, which provide authoritative information to help readers stay up-to-date with the latest developments in pediatric medicine. The content is peer-reviewed and undergoes rigorous evaluation to ensure its quality and reliability. Pediatrics also serves as a valuable resource for conducting new research studies and supporting education and training activities in the field of pediatrics. It aims to enhance the quality of pediatric outpatient and inpatient care by disseminating valuable knowledge and insights. As of 2023, Pediatrics has an impressive Journal Impact Factor (IF) Score of 8.0. The IF is a measure of a journal's influence and importance in the scientific community, with higher scores indicating a greater impact. This score reflects the significance and reach of the research published in Pediatrics, further establishing its prominence in the field of pediatric medicine.