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American Journal of Epidemiology Vol. 150, No. 1: 51-57
Copyright © 1999 by The Johns Hopkins University School of Hygiene and Public Health

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Prevalence and Determinants of Prone Sleeping Position in Infants: Results from Two Cross-Sectional Studies on Risk Factors for SIDS in Germany

M. Schlaud1 , C. Eberhard1, B. Trumann2, W. J. Kleemann3, C. F. Poets4, K. W. Tietze2 and F. W. Schwartz1

1Dept. of Epidemiology, Social Medicine and Health System Research, Hannover Medical School Germany
2Robert Koch Institute Berlin, Germany
3Institute of Legal Medicine, Hannover Medical School Germany
4Dept. of Pediatrics, Hannover Medical School Germany

The authors investigated whether there was a decline in infants sleeping prone and other modifiable risk factors for sudden infant death syndrome (SIDS) in Germany, where, as in some other countries, no nationwide intervention campaign against the prone sleeping position had been initiated. Data were obtained from parents by mailed questionnaires in two cross-sectional studies in 1991 (n = 3,330) and 1995 (n = 3,124). Prevalence of prone sleeping decreased from 37.6% to 8.7% (p < 0.05) in the German population and from 44.1% to 32.0% (p < 0.05) in the Turkish immigrant population. Parents who laid their infants prone in 1995 were less likely to follow advice from physicians, public media, and other parents (relative risks < 0.5, p < 0.05) and were more likely to have a low educational level, to be <20 years old, to be single parents, to have two or more children, to be raised in West Germany, or to be of Turkish ethnicity. Although the information on prone sleeping being a risk factor for SIDS became known among the population, these data suggest that subgroup-specific public intervention campaigns may be needed to reduce the prevalence of prone sleeping even further in those countries where no nationwide campaign has been initiated. Am J Epidemiol 1999;150:51–7.

cross-sectional studies; infant care; infant, sleeping position; intervention studies; prevalence; risk; sudden infant death

Reprint requests to Dr. Martin Schlaud, Dept. of Epidemiology, Social Medicine and Health Services Research, Hannover Medical School, 30623 Hannover, Germany.


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