Population trends in sudden infant death syndrome.

This review documents and assesses recent trends in sudden infant death syndrome. We review medical literature, Internet resources, and national governmental data. A striking reduction in SIDS incidence of more than 50% has been observed in various countries after interventions, particularly during the early 1990s, to reduce the prevalence of prone infant sleeping. A reduction in postneonatal mortality has accompanied these lower rates. Evaluation studies from several countries indicate that the SIDS rate drop is largely attributable to a decline in the proportion of babies sleeping prone. Within countries, the SIDS rate decline has not occurred to the same extent for different ethnic and socio-economic groups. Future public health activities must aim to address this issue. In the post-intervention era, the relative importance of the risk factors of side compared to supine sleeping and soft bedding near the infant's airway have become more evident. Recent death scene data indicate that a substantial proportion of the remaining SIDS deaths could be avoided by supine sleeping and by providing a safe sleeping environment for all infants.