In order to link the reported increasing incidence of SIDS in Sweden t
o environmental or other risk factors, we compared birth records and c
ircumstances of deaths in infants who died in 1975-1977 with those who
died a decade later, 1985-1987. The number of live births differed by
only 6850 in these two periods. Data were acquired from autopsy recor
ds of the deceased infants and matched with their respective birth cer
tificates which were obtained from the National Board of Health and We
lfare. The reported postperinatal incidence of SIDS increased from 0.5
1 per 1000 in 1975-1977 to 0.93 per 1000 in 1985-1987. No significant
differences in boy/girl ratio, birth weight, gestational age or age at
death were found in the two periods. While the number of infants who
died at night indoors in their own bed remained almost unchanged, the
number of infants who died outdoors in baby carriages during the cold
season increased almost four-fold. The observed increase in incidence
could, to a large extent, be related to the increase in outdoor deaths
. We speculate that increased incidence of smoking among young women a
s well as other changes in lifestyle may have been contributing factor
s.