640 - Maternal Decision-making Regarding Safe Sleep Practices Among Latina Mothers of Preterm Infants

Friday, April 28, 2023

5:15 PM – 7:15 PM ET

Poster Number: 640
Publication Number: 640.141

Erika G.. Cordova-Ramos, Boston Medical Center, Wellesley, MA, United States; Bryanne N. Colvin, Washington University in St. Louis School of Medicine, Saint Louis, MO, United States; Rachel E. Witt, University of Minnesota Medical School, Mahtomedi, MN, United States; Maria Estevez, Boston Medical Center, Boston, MA, United States; Eve R.. Colson, University of Washington School of Medicine, Saint Louis, MO, United States; Margaret Parker, UMass Memorial Medical Center, Worcester, MA, United States

Presenting Author(s)

Erika G. Cordova Ramos, MD (she/her/hers)

Assistant Professor of Pediatrics
Boston University School of Medicine
Wellesley, Massachusetts, United States

Background: Infant safe sleep practices (SSP) decreases the risk of Sudden Unexpected Infant Death (SUID). Preterm infants are at high risk of SUID. Compared to non-Latina mothers, Latina mothers of preterm infants report higher rates of unsafe sleep practices (e.g. prone sleeping, bedsharing). Factors that contribute to decision-making regarding sleep practices are unknown in this population.

Objective: To identify factors influencing decisions regarding infant SSP (e.g. sleep position, location) among Latina mothers of preterm infants.

Design/Methods: Using qualitative research methods, we conducted in-depth, semi-structured interviews with mothers of preterm infants (< 34 weeks’ gestation) 2-6 months after infant discharge. We used the theory of planned behavior (TPB) to design the interview guide and codebook. We included domains of the TPB: attitudes about the behavior, perceived control over the behavior, and perceived subjective norms (what others think) of the behavior. We developed themes iteratively and conducted interviews until reaching thematic saturation.

Results: We interviewed 21 mothers born in Central America and Mexico from 2 level III NICUs in Massachusetts and Colorado (Table 1). Within each TPB domain, we identified themes related to maternal decision-making that promoted and hindered adherence to SSP (Table 2). Attitudes: mothers’ perspectives of their preterm infants’ vulnerability and cultural beliefs strongly influenced SSP. Perceived control: mothers described how the use and quality of interpretation for safe sleep education, as well as hospital provision of safe sleep items (e.g. swaddle wraps) impacted their decisions. Social norms: mothers described the influence of cultural norms in home country on their decisions about SSP, and their partners as important sources of advice. When faced with conflicting advice, mothers made decisions based on trusted sources of advice.

Conclusion(s): Our findings demonstrate the need for interventions to promote SSP among Latina mothers of preterm infants that are grounded on cultural humility inclusive of family values, culture and beliefs; that address language barriers through access to quality interpretation; and involve important members of mothers’ social networks.