The term sudden infant death syndrome was proposed to describe a distinct disease entity with characteristic epidemiological, clinical, and pathological findings. Several commonly held etiologic theories were buried, among them allergic, traumatic, endocrine, and toxic causes. Common cold viruses were generally recognized as playing some role in the majority of cases of SIDS (Bergman et al., 1970). Although we can now describe SIDS and have limited knowledge about the mechanisms that produce the end result, our state of knowledge is still limited. Like the diseases leukemia, Reye's Syndrome, or juvenile rheumatoid arthritis, the diagnosis can be made, but the cause or causes and means of prevention remain elusive.
The incidence of SIDS, between two and three cases per thousand live births, is remarkably constant throughout the world wherever the disease has been studied. SIDS cannot be studied in an authoritative fashion without postmortem examinations performed on the victims. That's because other conditions such as bloodstream infections, viral infections of the heart, bleeding into the brain, and certain derangements of body chemistry might also cause an infant to die suddenly and unexpectedly. These other conditions can be excluded only by an autopsy. Because of their expense--currently running between $600 and $800 in the United States--and the shortage of trained pathologists, autopsies for deaths occurring outside a hospital must be considered a luxury item for all but medical-legal purposes, even in affluent countries. Medical-legal generally means that either the police or insurance companies need to know about the cause of death. In developing countries, which tend to have high infant mortality rates, autopsies for infant deaths are virtually unheard of. Therefore our knowledge possess the resources to conduct postmortem examinations.................
