BACKGROUND AND OBJECTIVES Maternal substance use during pregnancy heightens risk of sudden unexpected infant death (SUID), including through unsafe sleep practices. Families impacted by substance use frequently experience disproportionate social drivers of poor health and family vulnerability likely contributory to fatality risk. Characteristics of sleep-related SUID among infants born prenatally substance exposed versus nonexposed were compared to identify targeted prevention opportunities. METHODS Using the Sudden Death in the Young Registry, we examined SUID with sleep-related death between 2015 and 2020 across infants prenatally exposed versus nonexposed. Distribution of sleep environment characteristics, social drivers of poor health, and family vulnerability factors were examined using descriptive statistics and χ2. RESULTS Of 2010 infants who experienced sleep-related deaths, 283 (14%) were prenatally exposed. More than half of deaths involved an adult bed (52%, n = 1045) or surface sharing with an adult (53%, n = 1074). Supervisors of prenatally exposed infants were disproportionately impaired at infant death versus nonexposed (34%, n = 97 vs 16%, n = 279). Statistically significant associations between prenatal exposure history and vulnerability factors (insurance, child welfare involvement, intimate partner violence, health care barriers) were identified (P < .05). CONCLUSIONS Sleep-related SUID across infants prenatally exposed versus nonexposed differ in sleep environment characteristics and contributory social vulnerability. Disproportionate sleep environment hazards (surface sharing, supervisor impairment) are identified among prenatally exposed infants that should compel targeted prevention efforts, including safe sleep messaging, discouraging surface sharing, and engaging support persons during impairment periods. Addressing social needs and family vulnerability are also paramount to increase access to health care, safe sleep education, and material resource provision.

中文翻译：

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产前物质暴露婴儿中与睡眠相关的婴儿意外猝死。


背景和目标 孕期母体物质使用会增加婴儿意外猝死 （SUID） 的风险，包括通过不安全的睡眠习惯。受药物使用影响的家庭经常经历不成比例的健康状况不佳和家庭脆弱性的社会驱动因素，这可能导致死亡风险。比较产前物质暴露与未暴露婴儿的睡眠相关 SUID 特征，以确定有针对性的预防机会。方法 使用 Young 登记处的猝死，我们检查了 2015 年至 2020 年间产前暴露婴儿与未暴露婴儿的睡眠相关死亡的 SUID。使用描述性统计和 χ2 检查睡眠环境特征、健康状况不佳的社会驱动因素和家庭脆弱性因素的分布。结果 在 2010 名经历睡眠相关死亡的婴儿中，283 名 （14%） 产前暴露。超过一半的死亡涉及成人床 （52%，n = 1045） 或与成人共用床面 （53%，n = 1074）。产前暴露婴儿的监督者在婴儿死亡时与未暴露婴儿相比受损不成比例（34%，n = 97 vs 16%，n = 279）。确定了产前暴露史与脆弱性因素 （保险、儿童福利参与、亲密伴侣暴力、医疗保健障碍） 之间的统计学显着关联 （P < .05）。结论 产前暴露与未暴露婴儿的睡眠相关 SUID 在睡眠环境特征和促成社会脆弱性方面存在差异。 在产前暴露婴儿中确定了不成比例的睡眠环境危害（表面共享、监督者损伤），应迫使采取有针对性的预防工作，包括安全睡眠信息传递、劝阻共享表面以及在损伤期间让支持人员参与。解决社会需求和家庭脆弱性对于增加获得医疗保健、安全睡眠教育和物质资源供应的机会也至关重要。