SIDS' outstanding epidemiological characteristic is the age at which it strikes children. Most deaths occur at between 1 month and 6 months of age, with a peak between ages 2 and 3 months. Very vew cases occur before 1 month; the incidence drops significantly after 6 months old. SIDS deaths thus occur at an age when babies are undergoing their most rapid systemic development, and when their needs for efficient bodily processes and outside sources of energy to fuel them are greatest. Infants at this time are adjusting, for example, their sleep patterns to changing internal needs and to the outside environment, their gastrointestinal systems to changing foods, their immune systems to new antigens and pathogens, and their nervous systems to a variety of new motor and sensory stimuli. Life outside the womb is very different from life inside the womb.

SIDS strikes children of both sexes, of all social, economic, ethnic, and racial groups, and at all times of the year. The distribution of SIDS within these groups and seasons is not equal, however. About 60 percent of SIDS deaths occur among boys. SIDS occurs more commonly, but by no means exclusively, during the colder months of the year (autumn and winter), in both the northern and southern hemispheres. Members of lower socioeconomic groups generally suffer a higher incidence of SIDS than do others. The distribution of SIDS also seems to follow racial lines in the United States: Afro-Americans (blacks) show the highest incidence, followed by Euro-Americans (whites), followed by Asian-Americans. That racial distribution may be deceptive, as it probably reflects more the generally lower socioeconomic status (SES) of blacks in the United States compared to other groups. Low SES does not always translate into high risk for SIDS, however. Studies in both Chicago (Guntheroth 1989) and California (Grether and Schulman 1989) show, interestingly and, at present, inexplicably, that His-panics of low SES have a SIDS rate comparable to or lower than that for whites.

Certain other characteristics of babies, mothers, and families appear to be risk factors associated with a higher incidence of SIDS in infants. None of these factors is predictive of SIDS and none will be found in all SIDS cases, but all increase the risk in a child vulnerable to SIDS. All, it should be noted, can be related to low SES. Prematurity and low birth weight are both important risk factors in SIDS. SIDS occurs more frequently in children of the following: multiple births (increased risk due to small birth size or prematurity), younger mothers, mothers who smoke, mothers of greater parity, higher birth rank in the family, single mothers, mothers who are drug abusers, mothers with poor prenatal care, and families in which a SIDS death has previously occurred (slightly increased risk).

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