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

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 the 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 822 African-Americans and 1,708 Whites (N = 2,530). A significantly larger proportion of African-Americans (70.5%) compared to white women (53.5%) reported bed-sharing. For both races, breastfeeding, partner-related stress, and non-supine infant sleep position were significantly associated with bed-sharing, but no significant differences were found between the two racial groups. For African-Americans, maternal education of 13-15 years (OR: 1.92: 1.13-3.28) or greater than or equal to 16 years (OR: 2.54: 1.10-5.87) was associated with increased odds of bed-sharing, whereas Medicaid coverage for delivery was associated with decreased odds of bed-sharing (OR: 0.55: 0.37-0.81). For Whites, income of $35,000-$49,999 (OR: 1.70: 1.23-2.35), being unmarried (OR: 1.67: 1.18-2.35), and needing money for food (OR: 1.57: 1.16-2.14) were associated with bed-sharing. Conclusion. These findings demonstrate some common predictors of bed-sharing for both African-Americans and Whites. The findings also suggest the need for culturally-relevant strategies to examine the context of bed-sharing, the ecology of infant sleep, and information received by families.