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International Journal of Pediatrics
Volume 2009 (2009), Article ID 368270, 10 pages
http://dx.doi.org/10.1155/2009/368270
Review Article

A Unifying Theory for SIDS

1A. I. duPont Hospital for Children, Biomolecular Core Laboratory, 1600 Rockland Road, Wilmington, DE 19803, USA
2DuPont Haskell Global Centers for Health & Environmental Sciences, Investigative Sciences, Newark, DE 19711, USA

Received 8 May 2009; Revised 22 July 2009; Accepted 23 July 2009

Academic Editor: Edward F. Donovan

Copyright © 2009 David T. Mage and Maria Donner. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The Sudden Infant Death Syndrome (SIDS) has four distinctive characteristics that must be explained by any theory proposed for it. (1) A characteristic male fraction of approximately 0.61 for all postneonatal SIDS in the US; (2) a distinctive lognormal-type age distribution arising from zero at birth, mode at about 2 months, median at about 3 months, and an exponential decrease with age going towards zero beyond one year; (3) a marked decrease in SIDS rate from the discovery that changing the recommended infant sleep position from prone to supine reduced the rate of SIDS, but it did not change the form of the age or gender distributions cited above; (4) a seasonal variation, maximal in winter and minimal in summer, that implies subsets of SIDS displaying evidence of seasonal low-grade respiratory infection and nonseasonal neurological prematurity. A quadruple-risk model is presented that fits these conditions but requires confirmatory testing by finding a dominant X-linked allele protective against cerebral anoxia that is missing in SIDS.