Data Sheet 2_Risk and protective factors for sudden infant death syndrome (SIDS) in low-resource communities in Kolkata India: a mixed methods exploratory study of semi-structured interviews and survey data.xlsx

Sudden Unexpected Infant Death (SUID), Sudden Infant Death Syndrome (SIDS) and infant sleep practices are widely documented and studied in high-resource countries. Knowledge of SUID/SIDS occurrence, risk factors and protective factors in low or middle-resource countries such as India is lacking. This was an exploratory study using a mixed methods (qualitative and quantitative) approach to better understand infant sleep practices and the various factors that may influence them amongst caregivers in 5 low-income communities in Kolkata, India. Twenty-eight and 22 caregivers of infants <12 months old were recruited using a convenience sampling approach to participate in semi-structured interviews (phase 1) and a survey (phase 2), respectively. This research was conducted in partnership with Pratit International, a locally based NGO dedicated to providing comprehensive health care to disenfranchised communities in Kolkata. Analysis of qualitative and quantitative data found that infant caregivers frequently described risk factors (e.g., bedsharing, soft sleep surface, infant sleep position, objects in sleep area, environmental smoke exposure, low rates of pacifier use) and protective factors (e.g., breastfeeding, routine immunization/prenatal care, low rates of caregiver substance use) that have been associated with SIDS in high resource communities. Qualitative data revealed that certain caregivers' reasons for infant sleep position were rooted in cultural beliefs. Prenatal and postnatal sleep education given by a healthcare professional were limited and awareness of safer sleep advice in the community was low. These study findings suggest the need to provide safer sleep education resources in a culturally appropriate manner and can help guide future research on potential interventions such as the baby box.

婴儿猝死意外事件（Sudden Unexpected Infant Death, SUID）、婴儿猝死综合征（Sudden Infant Death Syndrome, SIDS）与婴儿睡眠行为，在高资源国家已得到广泛记录与研究。然而，印度这类中低资源国家中，关于SUID/SIDS的发生情况、危险因素与保护因素的相关认知仍较为匮乏。本研究为一项探索性研究，采用混合研究方法（mixed methods，定性与定量结合），旨在深入了解印度加尔各答5个低收入社区中婴儿照护者的睡眠行为及其潜在影响因素。本研究采用便利抽样法，共招募28名与22名月龄小于12个月的婴儿的照护者，分别参与半结构化访谈（第一阶段）与问卷调查（第二阶段）。本研究与本地非政府组织普拉蒂特国际（Pratit International）合作开展，该组织致力于为加尔各答境内的弱势社区提供全面医疗服务。对定性与定量数据的分析显示，婴儿照护者常提及的危险因素包括同床睡眠、柔软睡眠表面、婴儿睡眠姿势、睡眠区域内放置物品、环境烟雾暴露以及安抚奶嘴使用率低等；保护因素则涵盖母乳喂养、常规免疫接种/产前保健以及照护者物质使用率低等，上述因素均与高资源社区中的SIDS发病存在关联。定性数据还显示，部分照护者选择特定婴儿睡眠姿势的原因源于其文化信仰。由医疗专业人员提供的产前与产后睡眠教育资源较为匮乏，社区人群对安全睡眠建议的认知水平也较低。本研究结果表明，需要以契合文化背景的方式提供安全睡眠教育资源，同时也可为未来诸如婴儿安全箱（baby box）这类潜在干预措施的相关研究提供指导。