To the Editor.
——A major objective of the Centers for Disease Control (CDC) Mortality and Morbidity Weekly Report is to document disease trends accurately. The effort to achieve this goal in the CDC study on sudden infant death and seasonality1 was weakened by a failure to exclude cases certified as sudden infant death syndrome (SIDS) in which a death-scene investigation was not performed. Contrary to common belief, a high autopsy rate in a SIDS study confirmed by death certificate data does not strengthen the validity of this study when information is lacking concerning death-scene investigation of the presumed SIDS cases.2,3The observation by the author of the CDC report that the risk of SIDS was greatest for those white male infants whose mothers resided in the western United States must be cautiously interpreted since nonwhite Hispanic infants may be classified as white on death certificates. Because the incidence
Bass M. Seasonality in Sudden Infant Death Syndrome. JAMA. 1991;266(3):361-362. doi:10.1001/jama.1991.03470030061016