Abstract â–¡ 155

Background: SIDS is the leading cause of death for infants 1 month to 1 year of age in Georgia. SIDS deaths declined by 45%, from 195 deaths in 1989 to 109 deaths in 1996. The 1996 SIDS death rate in Georgia was 0.96/1,000 live births for all races, however, SIDS rates were higher in black infants (1.15/1000 live births) than white infants (0.85/1000 live births). We used the Pregnancy Risk Assessment Monitoring System (PRAMS), which added a question about sleep position in 1996, to assess sleep positioning among Georgia mothers.

Methods: Georgia PRAMS collects state-wide, population-based information on women's attitudes, experiences, and behaviors before, during, and after they deliver a live born infant. Once a month, a random sample of women is drawn from birth records, and women are contacted by mail or telephone (for nonresponders) within 2-6 months after delivery. In 1996, 1,761 women responded, with an average monthly response rate of 76%. We used SUDAAN to estimate population-level frequencies, taking into account sampling design, nonresponse, and noncoverage.

Results: Among all women, 25%, 45%, and 31% respectively, reported putting their babies to sleep on the back, side, and stomach. Side sleep positioning was the same for whites and blacks, but blacks were more likely than whites, 39% vs. 27%, to put their baby to sleep in the prone position, and less likely to put their babies to sleep in the supine position, 17% and 28% respectively.

Conclusions: Black mothers are more likely than white mothers to place their babies to sleep in the prone position, putting their infants at a higher risk of death from SIDS. Although nearly half of all mothers used the side sleeping position, special emphasis should be placed on putting the baby in the back sleep position, especially for black mothers. Due to the high prevalence of prone sleeping in the black population, the Georgia SIDS program is planning new efforts to reach black communities. Targeting these communities through outreach programs and hospitals should reduce the risk of SIDS.