Summary

  • Leading cause of infant death beyond the neonatal period.
  • Incidence roughly 1 in 2000 infants.
  • Peak incidence between 1 and 3 months of age, although events may occur up to 12 months of age.
  • Risk factors include exposure to tobacco smoke (prenatally and postnatally); prone and side sleeping; bed-sharing during sleep; a sleep environment that includes soft mattress and/or sleeping surface (including sofa or armchair), and placement of soft sleep bedding; overbundling/overheating; prematurity; exposure to alcohol and illicit drugs (prenatally and postnatally); and viral infection. Several risk factors may coexist in any given patient.
  • Protective factors include use of a pacifier during sleep, immunization, and breastfeeding.
  • Careful evaluation of death by trained forensics teams is necessary to rule out other causes of death, including suffocation, asphyxia, entrapment, infection, ingestions, metabolic diseases, arrhythmia-associated cardiac channelopathies, and trauma (accidental or nonaccidental).

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