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March 21, 2007

Sudden Infant Death Syndrome and Brain Abnormalities

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2007;297(11):1190-1191. doi:10.1001/jama.297.11.1190-b

To the Editor: Dr Paterson and colleagues1 studied the relationship between SIDS and serotonergic brainstem abnormalities in 31 infants dying of SIDS. However, as indicated in their Table 1, important data were missing or incomplete. In 7 cases, information was unavailable concerning the death scene, a major aspect in the diagnosis of SIDS by exclusion. Three cases of SIDS involved death in a car seat and 4 cases occurred in adult beds.2,3 The cause of death in these cases could have been unintentional asphyxiation, not SIDS.4 The question in these cases is how the data were obtained, how long after death they were obtained, and how thorough was the investigation. In all 31 cases, toxicologic results, if any, were not listed, even though use of cold medication in an infant can result in low-level toxicity that might play a role in sudden death.5