Elsevier

The Journal of Pediatrics

Volume 160, Issue 1, January 2012, Pages 44-48.e2
The Journal of Pediatrics

Original Article
Bed Sharing and the Risk of Sudden Infant Death Syndrome: Can We Resolve the Debate?

https://doi.org/10.1016/j.jpeds.2011.06.052Get rights and content

Objective

To conduct a meta-analysis on the relationship between bed sharing and sudden infant death syndrome (SIDS) risk.

Study design

Data from PubMed and Medline were searched for studies published after Jan 1, 1970. The search strategy included articles with the terms “sudden infant death syndrome,” “sudden unexpected death,” and “cot death” with “bed sharing” or “co-sleeping.” To further specify the potential risk of bed sharing and SIDS, subgroup analyses were performed.

Results

Eleven studies met inclusion criteria and were included in the final meta-analysis. The combined OR for SIDS in all bed sharing versus non-bed sharing infants was 2.89 (95% CI, 1.99-4.18). The risk was highest for infants of smoking mothers (OR, 6.27; 95% CI, 3.94-9.99), and infants <12 weeks old (OR, 10.37; 95% CI, 4.44-24.21).

Conclusions

Bed sharing is a risk factor for SIDS and is especially enhanced in smoking parents and in very young infants.

Section snippets

Methods

In the search for all relevant studies, two of the authors (M.V., C.C.) independently searched PubMed and Medline for these subjects: “sudden infant death syndrome,” “sudden unexpected death,” and “cot death” with “bed sharing” or “co-sleeping.” In addition, all reference lists of the relevant studies were checked to find additional studies that may have been overlooked. Finally, participants at the “Epidemiology Working Group” of the International Society for the Study and Prevention of

Results

Eleven case-control studies were included in the meta-analysis.3, 16, 17, 21, 22, 23, 24, 25, 26, 27, 28 First author, country, number of cases and controls, the total number of subjects in each study, and univariate and multivariate ORs with 95% CI for the risk of SIDS are shown in the Table. The flow diagram describing inclusion and exclusion of studies is shown in Figure 1 (available at www.jpeds.com). The forest plot for the multivariate ORs with the random effect model is shown in Figure 2.

Discussion

In our meta-analysis we included 2464 cases and 6495 controls. When the study-specific multivariable ORs were combined, the summary OR for SIDS was 2.89 (95% CI, 1.99-4.18). Despite indications of heterogeneity, there was not a single study showing a reduced risk of SIDS in bed-sharing infants; all studies found an increased risk.

In the studies that presented data on maternal smoking, the risk associated with bed sharing increased even further. The 4 studies considered here all reported on

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    The authors declare no conflicts of interest.

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