[Sudden infant death syndrome (SIDS): risk conditions and intervention strategies]

The term SIDS describes the unexpected and unexplained death of an apparently well infant. After congenital anomalies, SIDS is the most common cause of infant death in the industrial countries and it is the leading cause of death among infants older than 1 month. Descriptive epidemiological studies have shown a winter excess of cases and a peak of age distribution at about 3 months of age. Although many theories have been proposed to explain the etiology (i.e. fatal toxaemia, autonomic dysfunction, abnormalities of respiratory or cardiovascular control), an underlying cause for SIDS has not been identified. There are, however, a number of factors consistently associated with an elevated risk, the strongest of which are maternal smoking or exposure to substances of abuse during pregnancy, overheating and overinsulation, artificial feeding and prone sleeping position. A fall in the rate of the SIDS can be reasonably expected from changes in these risk factors, from home monitoring of infants suffering a near-SIDS episode and of siblings of SIDS victims, and from parental education programmes.