Epidemiology


  • Peak incidence: 2–4 months

Etiology


  • Definition: Sudden, unexpected death of an infant < 1 year of age that remains unexplained after a thorough case investigation (autopsy, death scene, and clinical history).
  • Peak incidence: 2 to 4 months of age (90% occur before 6 months).
  • Modifiable Risk Factors:
    • Prone or side-sleeping position (highest risk).
    • Soft sleep surfaces and loose bedding (pillows, bumper pads, plush toys, quilts).
    • Bed-sharing / Co-sleeping (especially on couches, with smokers, or if parents are impaired/fatigued).
    • Overheating / Overbundling (excessive clothing, high room temperature, head coverings).
    • Maternal smoking (prenatal and postnatal) or secondhand smoke exposure.
    • Maternal alcohol or illicit substance use.
    • Lack of prenatal care, young maternal age (< 20 years).
  • Non-Modifiable Risk Factors:
    • Prematurity (< 37 weeks gestation) and low birth weight (LBW).
    • Male sex.
    • Sibling history of SIDS.
  • Protective Factors:
    • Supine sleeping position (“Back to Sleep”).
    • Room-sharing without bed-sharing for the first 6 months.
    • Pacifier use at sleep time.
    • Breastfeeding (exclusive or partial).
    • Up-to-date immunizations.
    • Firm, flat mattress with a tight-fitting sheet.

Pathophysiology


Clinical features


Abrupt and unexplained death of an infant

Diagnostics


Treatment


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