The sudden infant death syndrome: a review of recent advances.

When deaths during the first year of life are sudden, unexpected, and unexplained by any clinical or routine postmortem finding, they are placed in the category of sudden infant death syndrome (SIDS). The syndrome may have many causes, but there are probably only a few final pathways to death. Much recent evidence supports sleep apnea as the most common of these final pathways. Several SIDS victims have had reccurent episodes of sleep apnea prior to death. Such episodes are associated with chronic underventilation of the lungs in other disorders, and more than half of SIDS victims have postmortem markers of antecedent chronic underventilation and hypoxemia. The hypoventilation-apnea hypothesis is also attractive because it fits most of the unique epidemiologic features of SIDS.