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Epidemiologic research into sudden infant death syndrome (SIDS) has resulted in the recognition of factors that place an infant at increased risk of SIDS. The avoidance of these risk factors promulgated through public education programs, such as the “Reduce the Risk” campaign in Australia, New Zealand, and Western Europe as well as the “Back to Sleep” campaign in the United States, led to astounding reductions in SIDS rates in these communities.1
Although these risk factors may provide clues to causation, the ultimate clarification of the mechanisms of death in SIDS will require basic research in pathology. For example, prone sleep position is a very important risk factor for SIDS, but its role in the cause of death remains an enigma. External airway obstruction,2,3 rebreathing into soft sleep surfaces,4–6 hyperthermia,7 and increased frequency of mild infectious symptoms combined with a stimulated mucosal immunoglobulin A system of the larynx, inducing release of cytokines in …
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