COT DEATHS - EXPERIENCE OF A REFERRAL CENTER, 1986-1991

Background. Sudden infant death syndrome (SIDS) may have several etiol ogies, all of which must be identified in order to recognize those inf ants believed to be at risk. One of the best ways to do this is by pro spective studies on a large population of infants who died of SIDS. Me thods. A total of 171 infants who died from SIDS between January 1, 19 86 and June 30, 1991, were studied. 154 infants were completely invest igated, including a post mortem examination. They were assigned to one of 4 groups, according to whether death was due to diseases of poor p rognosis (group A), diseases that are occasionally fatal but potential ly treatable (group B), minor diseases not normally fatal (group C), o r was essentially unexplained (group D). Results. The classical risk f actors for SIDS were found in this population: incidence peaked in mal es (sex-ratio 1.5), during the cold seasons (62%), between 1 and 6 mon ths of age (94%), mainly between 1 and 4 months of age (84%). Symptoms were definitely present during the 2 days before death in 50%. 20% of cases had clinical histories of congenital disease, complicated or re current postnatal disease, or fulminant recent disease. Group A includ ed 107 infants (69% of the 154 completely investigated patients). Prem ature birth (17.5%) and low birth weight for gestational age (10.5%) w ere more frequent in our series than in the normal population. Conclus ion. The cause of death was identified in about 75% of cases. This pos sibility improves management of further siblings of SIDS victims even though the variety of risk factors makes prevention of SIDS difficult.