Sudden Infant Death Syndrome (SIDS)
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- Sudden, unexpected death of an infant <1 yr old who was typically well before being placed down to sleep
- Death remains unexplained after being thoroughly investigated by autopsy, exam of the death scene, investigation of the circumstances, and review of the family and infant medical histories.
- Leading cause of death in infants 1 mo–1 yr of age; the incidence has declined markedly since the initiation of the “Back to Sleep” program in 1994:
- 1992: 120 deaths/100,000 live births (US)
- 2001: 56 death/100,000 live births (US)
- No change from 2001–2006
- Peak occurrence of SIDS at 1–4 mo of age:
- 90% occur <6 mo of age
- 2% occur >10 mo of age
- Ethnic differences: 2006 rates per 100,000 live births: All populations, 54.5; non-Hispanic white, 55.6; non-Hispanic black, 103.8; American Indian/Alaska Natives, 119.4; Asian American or Pacific Islander, 22.8; Hispanic, 27.
- Sleeping on back (supine) reduces incidence significantly (“Back to Sleep”). Practice of infants sleeping on their backs began initially in Europe and then in US
- Most likely multifactorial
- SIDS infants likely have predisposing conditions that make them more vulnerable to both internal and external stressors.
- Potential stressors include anemia, congenital diseases, dysrhythmias, electrolyte abnormalities, genetic defects, infection, metabolic disorders, neurologic events, suffocation, trauma, upper airway obstruction.
- Maternal and antenatal risk factors:
- Alcohol and illicit drug use
- Intrauterine growth restriction
- Lower socioeconomic status
- Poor prenatal care
- Prior sibling death secondary to SIDS
- Shorter interval between pregnancies
- Younger age
- Infant risk factors:
- Bed sharing
- Exposure to environmental smoking
- Gastroesophageal reflux (GER)
- Low birth weight, prematurity
- Male gender
- Soft bedding, soft sleeping surface
- Recent febrile illness
- Supine sleeping position, breast-feeding, and pacifier use are protective.
- Home monitoring has not been shown to prevent SIDS.