THE CHANGING EPIDEMIOLOGY OF SUDDEN-INFAN T-DEATH-SYNDROME IN AUSTRIA- REALITY OR FALLACY

After the rise in incidence of the sudden infant death syndrome (SIDS) in the 1980s to a peak of 1.7/1000 live births in Austria in 1988, th e SIDS rate more than halved to 0.79/1000 live births in 1994. This tr end can be regarded as typical of the epidemiology of SLDS in most Wes tern countries. It is commonly interpreted as a result of preventive m easures. However, the decline in incidence of SIDS started several yea rs before systematic preventive activities were undertaken in Austria. Graphical presentation shows that the dynamics of SIDS does not affec t the almost linear decline in postneonatal mortality over the past 25 years, as would be expected from the fact that SIDS is the most impor tant cause of death in the postneonatal period. A comparative analysis of trends of postneonatal SLDS and non-SIDS mortality reveals that in Austria the increase of SIDS was accompanied by a rapid fail of non-S IDS mortality, whereas. on the contrary, the decline of SIDS went alon g with relative increase of non-SIDS mortality. Changing awareness of coroners and forensic pathologists of SIDS, with the resultant changes in frequency and performance of post mortem examinations, and changes in coding practices of causes of death should be taken into considera tion as determinants of SIDS incidence before interpreting trends as r esulting from public health interventions.