Concurrent Risks in Sudden Infant Death Syndrome

Despite improved education on safe sleep, infants are still exposed to multiple risks for sudden infant death syndrome (SIDS). Variability among health care providers continues to exist regarding knowledge of risk factors and the provision of education to caregivers. To enhance the content and delivery of SIDS risk-reduction initiatives by physicians and other health care providers and to provide them with a context for evaluating their discussions of risks and compensatory strategies, we sought to raise awareness of the frequency of risk factors in SIDS cases, patterns of co-occurrence, associations between modifiable and nonmodifiable risks, and the rarity of cases without risk. In a population-based retrospective review of 244 (97%) New Jersey SIDS cases (1996-2000), we assessed the frequencies and co-occurrences of modifiable (maternal and paternal smoking, nonsupine sleep or prone status at discovery, bed-sharing, or scene risks) and nonmodifiable (upper respiratory infection or