In this issue of AJDC, Alo et al1 report their efforts to determine the causes of the high mortality rate of black infants in the United States. They matched birth and death certificates and found that the causes of the high infant mortality rate from 1980 to 1989 among blacks in Illinois fell into three categories: complications of preterm birth, congenital anomalies, and sudden infant death syndrome (SIDS). As would be expected, no information was available from the death certificates about the initiating causes of the preterm births, the congenital anomalies, or SIDS.
What are the disorders that initiate the high frequencies of preterm birth, congenital anomalies, and SIDS in blacks? There are no simple genetic or teratogenic explanations for the high frequency of congenital anomalies reported by Alo et al.1 The prospects are better for identifying the causes of the excessive preterm births