Multiple Risk Factors Exist in Most Sudden Infant Death Syndrome Cases

Maternal smoking occurred in 42.6% of the cases with data on this risk, and 98% among those cases that had additional risks. At least one risk factor was found in 96% of the cases, and 78% had up to seven risk factors. Nine of the of 244 risk-free cases (3.7%), 7 lacked data; on the basis of the complete data, only 2 (0.8%) of all 244 cases were found to be risk free. When nonmodifiable risks were excluded, 5.3% of the cases met this definition. The study was published ahead of print on February 15, 2010, in the journal Pediatrics.

"Risk-reduction education of new parents and all other caregivers, such as grandparents and babysitters should be detailed,” said study coauthor Prof. Thomas Hegyi, M.D., of the department of pediatrics, who also serves as the medical director of the SIDS Center of New Jersey. "Parent's questions and concerns should be addressed thoroughly.”

SIDS is defined as a sudden and unexpected death of an infant before the first birthday that remains unexplained even after a comprehensive evaluation consisting of a complete autopsy, a death scene investigation, and a review of medical history of the infant and the family. Many studies now suggest that one of the potential causes may be an abnormality in the brainstem that would prevent an infant from responding to breathing challenges, such as those posed by prone sleep in soft bedding.

Guidance to parents regarding safe sleep practices should address the importance of sleeping on the back (the position associated with the lowest risk), but also should cover all other practices that have been identified as lowering the risk of SIDS, including, but not limited to, avoidance of exposure to tobacco smoke, elimination of the use of pillows, quilts, and soft or loose bedding in the infant's sleep environment, avoidance of any facial covering, and avoidance of the use of a shared sleep surface during sleep.

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