Online Program

Factors associated with racial disparities in maternal-infant bed-sharing: Findings from Wisconsin

Wednesday, November 6, 2013

Trina Salm Ward, PhD, MSW, CAPSW, Zilber School of Public Health and Center for Urban Population Health, University of Wisconsin-Milwaukee, Milwaukee, WI
Emmanuel Ngui, DrPH, MSc, Joseph J. Zilber School of Public Health,, University of Wisconsin-Milwaukee, Milwaukee, WI
Mary Kay Madsen, PhD, RN, FAAIDD, College of Health Sciences, University of Wisconsin Milwaukee, Milwaukee, WI
Ron A. Cisler, PhD, Center for Urban Population Health, University of Wisconsin-Milwaukee, Milwaukee, WI
Background. Although the American Academy of Pediatrics has recommended a separate but proximate sleep surface for infants since 2005, maternal-infant bed-sharing remains a common practice, especially among African-Americans. Bed-sharing has been associated with a higher risk of Sudden Infant Death Syndrome, which affects African-Americans at a disproportionately higher rate. This study examined factors associated with bed-sharing (main outcome) among African-American and White mothers.

Methods. Analysis of the 2007-2010 Wisconsin Pregnancy Risk Assessment and Monitoring System (PRAMS) using separate logistic regression models for African-Americans and Whites.

Results. The sample consisted of 806 African-Americans and 1,680 Whites (N = 2,486). A significantly larger proportion of African-Americans (70.6%) reported bed-sharing than Whites (53.4%). For both races, partner-related stress was significantly associated with bed-sharing; no significant differences were found between the two racial groups. For African-Americans, partner stress (OR: 1.79: 1.22-2.63) and maternal education of 13-15 years (OR: 1.99: 1.16-3.42) or ≥ 16 years (OR: 2.67: 1.14-6.27) was associated with increased odds of bed-sharing. For Whites, partner stress (OR: 1.34: 1.02-1.76), breastfeeding (OR: 2.48: 1.93-3.11), income of $35,000-$49,999 (OR: 1.64: 1.18-2.29), being unmarried (OR: 1.54: 1.08-2.2), needing money for food (OR: 1.58: 1.09-2.3), and non-supine sleep position (OR: 1.75: 1.17-2.61) were associated with bed-sharing.

Conclusion. Differences were found in bed-sharing factors were found between racial groups, which suggests a need for culturally-relevant, tailored safe infant sleep interventions. Providers should ask families about their infant's sleeping environment and address safety issues within that environment. More research is needed on the context and reasons for bed-sharing.

Learning Areas:

Assessment of individual and community needs for health education
Public health or related research
Social and behavioral sciences

Learning Objectives:
Compare the different factors associated with bed-sharing between African-American and white families in Wisconsin.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I earned an Interdisciplinary PhD in Health Sciences from the University of Wisconsin-Milwaukee with an interest in population health, and my research interest is focused on the application of mixed methods, community-based research approaches to pregnancy and infant health outcomes (low birth weight, preterm birth, and infant death), specifically addressing racial disparities in these outcomes. My dissertation was focused on examining factors associated with maternal-infant bed-sharing, specifically examining differences by racial group.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.