Preemies at Greater Risk of SIDS and Other Sleep-Related Deaths

Despite widespread education on safe sleeping practices for newborn babies, infants born prematurely are still at greater risk of sudden infant death syndrome (SIDS) and other sleep-related deaths compared to full-term babies.

The study, published in the journal Pediatrics, found that infants born between 24 to 27 weeks were more than three times as likely to die before their first birthday of a sudden unexpected infant death, including SIDS and other sleep-related infant deaths, than full-term babies.

The risk remained high even after adjusting for factors such as smoking and inadequate prenatal care. And while the risk decreased for premature infants born closer to full-term, it was still significantly higher than the risk for full-term babies, according to the study.

“While we can’t undo a preterm birth, we can help compensate for the accompanying elevated risk of sudden infant death syndrome and other sleep-related infant deaths by helping families adopt the beneficial practices that include putting an infant on his back to sleep and keeping the sleep environment clutter free,” said Barbara Ostfeld, professor of pediatrics at Rutgers Robert Wood Johnson Medical School and program director of the SIDS Center of New Jersey.

Every year in the United States about 3,500 infants die of a sleep-related death, a significant decrease from 25 years ago when the American Academy of Pediatrics (AAP) released its landmark guidelines that all babies should be placed on their back to sleep.

New recommendations were released again in 2011 and 2016 to address SIDS other sleep-related deaths — 25 percent of which are caused from suffocation, entrapment, and asphyxia — which have increased. The AAP also recommended keeping infants in a consumer product safety commission approved crib, bassinet, or portable crib near the parent’s bed.

“It’s important that neonatal intensive care units assess how well they are complying with these guidelines and teaching about safe infant sleep practices,” said Ostfeld. “Pediatricians need to remind parents and grandparents at every office visit.”

Ostfeld said researchers need to develop more evidence-based interventions for increasing compliance with safe sleep practices, and also need to address potentially treatable intrinsic factors that elevate risk for the preterm infant. Besides unsafe sleep practices, other causes for infant mortality include smoking, poor prenatal care, and poverty, she said.

For the study, the researchers examined infant birth and death certificates between 2012 and 2013 and found the risk of dying from SIDS and other sleep-related causes in the first year was highest for those born between 24 and 27 weeks. While 0.51 deaths were reported for every 1,000 births between 39 to 42 weeks, there were 2.68 deaths for every 1,000 births between 24 and 27 weeks.

“Prematurity is a challenge,” said co-author Thomas Hegyi, professor of pediatrics at Robert Wood Johnson and medical director of the SIDS Center of New Jersey. “What we need to do is make sure parents and families understand what they can to do when they leave the hospital to keep their baby safe.”

Source: Rutgers University