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DEFINITION

Sudden Infant Death Syndrome-- (SIDS) is more commonly known as 'cot death'. Although SIDS does not necessarily only happen in cots. It may occur in a pram, bed, car seat or anywhere a baby is resting.
In a typical example, a seemingly healthy infant is put down to sleep and when the infant is next checked they are found dead. There has been no sound or sign of a struggle.

In the past SIDS has been defined as:"The sudden death of an infant or young child, which is unexpected by history, and in which a thorough post mortem examination fails to demonstrate an adequate cause of death" [Beckwith et al, 1969].
Other terms used on death certificates in more recent years are: 'unascertained', 'undetermined' or 'sudden unexpected death in infancy'.

Recently there has been a new definition proposed [Krous et al, 2004]:
General DefinitionSIDS is defined as the sudden unexpected death of an infant less than 1year of age, with the onset of the fatal episode apparently occurring during sleep, that remains unexplained after a thorough investigation, including performance of a complete autopsy and review of the circumstances of death and the clinical history.

Category IA SIDS: Classic features of SIDS present and completely documentedThis category should include infant deaths that meet the requirements of the general definition and all of the following criteria:
  • More than 21days and less than 9 months of age
  • Normal Clinical history (including gestational age >= 37wks)

Category IA SIDS: Classic features of SIDS present and completely documented (cont'd)
  • Normal growth and development
  • No similar deaths among siblings or close genetic relatives
  • Death scene investigation carried out
  • Found in a safe sleeping environment with no evidence of accidental death

Category IB SIDS: Classic features of SIDS present but incompletely documentedThis category should include infant deaths that meet the requirements of the general definition and all of the criteria for Category IA except death scene investigation was not performed and or >= 1 of the following analyses was not performed: toxicology, microbiology, radiology, vitreous chemistry, or metabolic screening.

Category II SIDSThis category should include infant deaths that meet category I criteria except for >=1 of the following:
  • Age range outside of category IA or IB (i.e. 0-21days or 9mths - 1yr)
  • Similar deaths among siblings or close relatives
  • Neonatal or Perinatal conditions(e.g. preterm birth) that have resolved by the time of death
  • Mechanical asphyxia or suffocation caused by overlaying not determined with certainty
  • Abnormal growth and development not thought to have contributed to death
  • Marked inflammatory changes not sufficient to be unequivocal causes of death

Unclassified Sudden Infant DeathThis category should include infant deaths that do not meet criteria for category I or II SIDS but for which alternative diagnoses of natural or unnatural conditions are equivocal.

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