Abstract â–¡ 157

Sudden infant death syndrome (SIDS) is a major cause of postnatal mortality in developed countries. In Romania, the incidence of SIDS is very low. The aim of the study was to investigate the infant care practice in the North of Romania and to determine whether the SIDS related risk factors have any influence on the low incidence of this syndrome.

Material and methods. The study included 100 infants from the urban area and 83 from rural area of Cluj district. All socioeconomic classes were represented. Data were collected from parents at their homes. The interview contained sociodemographic information: age of the infant, gender, birth weight, feeding, morbidity, age, education and occupation of the parents; parity, number and age of the others children; sleeping habits including room heating, cosleeping, sleep position, bedclothes, awakening and tobacco smoke exposure of the infant.

Results. The infants, 48.6% girls and 51.4% boys (p=0.54), were born at term 77.6% were breastfed for about 3.5-10 months. The mothers, 27.6+4.5 years old in urban and 25.4+4.4 years in rural area (p=0.003), were housewives (30%), workers (36.6%), intellectuals (16.9%), technicians (16.4%) and 23% were smokers. About 92.3% of the fathers had stable jobs. Only 9.8% of the infants sleept alone in the room, others were sharing the room with the parents (40.4%), the mother (20.2%), parents and brothers (24.6%), brothers (3.3%) and 1.7% with their father in a room temperature of about 22°C The mothers placed the infant in a basket (78.8%) in the first 4 month of life and 18% were sharing their beds with the infant. The infants were put in supine (47%), side (44.3%) and prone (8.7%) and were found when awoke in supine (39.3%), side (33.3%) prone (13.1%) and various positions (13.1%). Half of the infants (51.9%) used the tummy during sleeping. In the cold season, the infants were covered with a blanket (65.4%), counterpane (27.7%) or sleeping bag (9.9%), none being completely covered by bedding. The head, but not the face, was covered during the sleep in 42.6% of the infants. The beds had natural fiber mattresses (84.7%) and syntetical mattresses (15.3%). The parents used for swadding cotton diaper only (46.1%), pampers (35%) or the both (17.9%). None infant was exposed to thermal insultation by room heating, overbedding or overclothing. There was no difference between urban and rural area in parity, infant birthweight, breast feeding, bedding and tummy using. The mothers from the urban area had a higher education and occupation, preferred to put their infants in prone position and their breast feeding period was shorter (p=0.003). In the rural area we found a higher incidence of cosleeping in the room, of natural fiber mattresses and cotton diapers, of head covering and of infant exposure to tobacco smoke (p=0.006). The infants awoke 1-4 times in the night, more frequently in these breastfed, bed shared, cotton diaper swaddled, put on a side to sleep in discontinuously heated rooms and smoke exposed infants (p=0.04).

Conclusion. The risc factors contributing to SIDS, such as prone position sleeping, completely covering by bedding, bed sharing, overheating and smoke exposure show a low incidence in our country.