ArticleBMJ paediatrics open2026
Maternal adherence to safe infant sleep recommendations in the USA: trends and disparities from PRAMS 2016-2022.
Article in BMJ paediatrics open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07779512 (A Pediatric Emergency Department-based Intervention to Increase Infant Adherence to Safe Sleep Practices), which is not on this map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Pediatric Emergency Department-based Intervention to Increase Infant Adherence to Safe Sleep Practices
Who cites it
1 citing paper in PubMed.
- Trial
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeSleep-related infant deaths in the USA have plateaued despite long-standing evidence-based recommendations for safe sleep. Understanding maternal patterns of adherence and associated disparities is critical to improving infant safety. Using nationally representative Pregnancy Risk Assessment Monitoring System (PRAMS) Phase 8 surveillance data (2016-2022), we estimated adherence to four safe sleep recommendations, examined temporal trends and assessed sociodemographic and behavioural correlates of non-adherence.
methodsWe analysed 125 931 weighted maternal responses (weighted count: 6 372 445) on infant sleep position, location, surface and bedding. Temporal trends were assessed using log-linear regression and expressed as the average annual percentage change (APC). Disparities were examined using multiple logistic regression, reporting adjusted ORs (AORs) and 95% CIs.
resultsAdherence was highest for supine sleep position (79.8%; 95% CI 79.4 to 80.2) and lowest for safe bedding (32.8%; 95% CI 32.4 to 33.2). Significant improvements were observed in adherence to safe bedding (APC=11.5%) and safe sleep surfaces (APC=2.8%). Compared with non-Hispanic white mothers, non-Hispanic black mothers had substantially higher odds of unsafe practices, including non-supine position (AOR 3.4; 95% CI 3.2 to 3.7), infant bed-sharing (AOR 2.4; 95% CI 2.3 to 2.6), unsafe sleep surfaces (AOR 1.5; 95% CI 1.4 to 1.6) and loose bedding (AOR 3.6; 95% CI 3.3 to 3.9). Elevated risks were also seen among Hispanic mothers, Medicaid or uninsured, unmarried, smokers and those not receiving healthcare worker advice.
conclusionMaternal adherence to safe sleep recommendations remains low, with persistent sociodemographic disparities. These findings highlight the need for stronger integration of safe sleep counselling within antenatal and postpartum care.
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