title: Prevention of sudden infant death syndrome (SIDS) due to an active health monitoring system 20 years prior to the public "Back to Sleep" campaigns.
abstract: BACKGROUND
  Before reunification, the post-neonatal mortality rate was lower in East Germany than in West Germany. Moreover, the incidence of SIDS (sudden infant death syndrome) was much lower in the East.
  
  
  METHODS
  Mortality data on sudden infant death syndrome (SIDS) from West and East Germany since 1980 as well as post-neonatal mortality data for both states since 1970 were examined. 95% Confidence intervals were calculated for the rates. Witnesses from the former East Germany who were involved at the time were also interviewed and archives were searched.
  
  
  RESULTS
  We found that as early as 1972 active monitoring of infant and child mortality rates in East Germany had shown that the prone sleeping position was dangerous for infants: the post-neonatal mortality rate was approximately 1 per 1000 live births lower in East than in West Germany during the 20 years before reunification. In contrast, in the West, prone sleeping was only discovered to be a risk factor for SIDS in the early 1990s.
  
  
  CONCLUSIONS
  Active monitoring is an effective tool in the early detection of risk factors and serves to prevent unnecessary deaths.
authors.affiliation: Institute of Legal Medicine, University of Münster, Germany. vennemam@uni-muenster.de
authors.forename: M
authors.initials: M
authors.lastname: Vennemann
authors.forename: D
authors.initials: D
authors.lastname: Fischer
authors.forename: G
authors.initials: G
authors.lastname: Jorch
authors.forename: T
authors.initials: T
authors.lastname: Bajanowski
mesh_terms: D001344:Autopsy; D005859:Germany, East / Q000453:epidemiology; D005860:Germany, West / Q000453:epidemiology; D006293:Health Promotion; D006801:Humans; D007223:Infant; D007224:Infant Care / Q000379:methods; D007231:Infant, Newborn; D016684:Prone Position; D012307:Risk Factors; D013398:Sudden Infant Death / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*