Skip to main content

Advertisement

Log in

Sudden twin infant death on the same day: a case report and review of the literature

  • Case Report
  • Published:
Forensic Science, Medicine, and Pathology Aims and scope Submit manuscript

Abstract

Sudden infant death syndrome (SIDS) is a major contributor to infant mortality. The cause of death is unknown: suggested possibilities include cardiovascular disease, anaphylactic shock, and suffocation. The occurrence of simultaneous sudden infant death syndrome is uncommon, such cases being extremely rare in forensic pathologic practice. We report two 10-week-old male twins who appeared well at the time of their evening feeding, yet died while sleeping on their backs. Both infants had petechial hemorrhages on the visceral pleura, epicardial surface of the heart, and thymus gland. Microscopic examination revealed pulmonary edema, intra-alveolar hemorrhage, and minor lymphocytic infiltration, again in both infants. In this report, we discuss the risk factors for SIDS, which should be considered individually or in combination as possible causes of death.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

References

  1. Bajanowski T, Vege A, Byard RW, Krous HF, Arnestad M, Bachs L, et al. Sudden infant death syndrome (SIDS)-standardised investigations and classification: recommendations. Forensic Sci Int. 2007;165(2–3):129–43.

    Article  PubMed  Google Scholar 

  2. Li L, Fowler D, Liu L, Ripple MG, Lambros Z, Smialek JE. Investigation of sudden infant deaths in the State of Maryland (1990–2000). Forensic Sci Int. 2005;148(2–3):85–92.

    Article  PubMed  CAS  Google Scholar 

  3. Tursan d’Espaignet E, Bulsara M, Wolfenden L, Byard RW, Stanley FJ. Trends in sudden infant death syndrome in Australia from 1980 to 2002. Forensic Sci Med Pathol. 2008;4(2):83–90.

    Article  PubMed  Google Scholar 

  4. Wedekind H, Bajanowski T, Friederich P, Breithardt G, Wulfing T, Siebrands C, et al. Sudden infant death syndrome and long QT syndrome: an epidemiological and genetic study. Int J Legal Med. 2006;120(3):129–37.

    Article  PubMed  Google Scholar 

  5. Kinney HC, Thach BT. The sudden infant death syndrome. New Eng J Med. 2009;361(8):795–805.

    Article  PubMed  CAS  Google Scholar 

  6. Getahun D, Demissie K, Lu SE, Rhoads GG. Sudden infant death syndrome among twin births: United States, 1995–1998. J Perinatology. 2004;24(9):544–51.

    Article  Google Scholar 

  7. Malloy MH. Sudden infant death syndrome among extremely preterm infants: United States 1997–1999. J Perinatology. 2004;24(3):181–7.

    Article  Google Scholar 

  8. Malloy MH, Freeman DH Jr. Sudden infant death syndrome among twins. Arch Ped & Adolescent Med. 1999;153(7):736–40.

    CAS  Google Scholar 

  9. Ladham S, Koehler SA, Shakir A, Wecht CH. Simultaneous sudden infant death syndrome: a case report. Am J Forensic Med Pathol. 2001;22(1):33–7.

    Article  PubMed  CAS  Google Scholar 

  10. Balci Y, Tok M, Kocaturk BK, Yenilmez C, Yirulmaz C. Simultaneous sudden infant death syndrome. J Forensic Leg Med. 2007;14(2):87–91.

    Article  PubMed  Google Scholar 

  11. Mitchell EA, Elder DE, Zuccollo J. Simultaneous sudden unexpected death in infancy of twins: case report. Int J Leg Med. 2010;124(6):631–5.

    Article  Google Scholar 

  12. Saukko PJ, Knight B. Knight’s forensic pathology. London: Arnold; 2004.

    Google Scholar 

  13. Koehler SA, Ladham S, Shakir A, Wecht CH. Simultaneous sudden infant death syndrome: a proposed definition and worldwide review of cases. Am J Forensic Med Pathol. 2001;22(1):23–32.

    Article  PubMed  CAS  Google Scholar 

  14. Smialek JE. Simultaneous sudden infant death syndrome in twins. Pediatrics. 1986;77(6):816–21.

    PubMed  CAS  Google Scholar 

  15. Beal S. Sudden infant death syndrome in twins. Pediatrics. 1989;84(6):1038–44.

    PubMed  CAS  Google Scholar 

  16. Malloy MH, Hoffman HJ. Prematurity, sudden infant death syndrome, and age of death. Pediatrics. 1995;96(3Pt1):464–71.

    PubMed  CAS  Google Scholar 

  17. Vennemann MM, Bajanowski T, Brinkmann B, Jorch G, Sauerland C, Mitchell EA, et al. Sleep environment risk factors for sudden infant death syndrome: the German Sudden Infant Death Syndrome Study. Pediatrics. 2009;123(4):1162–70.

    Article  PubMed  Google Scholar 

  18. Ostfeld BM, Perl H, Esposito L, Hempstead K, Hinnen R, Sandler A, et al. Sleep environment, positional, lifestyle, and demographic characteristics associated with bed sharing in sudden infant death syndrome cases: a population-based study. Pediatrics. 2006;118(5):2051–9.

    Article  PubMed  Google Scholar 

  19. Ramos V, Hernandez AF, Villanueva E. Simultaneous death of twins. An environmental hazard or SIDS? Am J Forensic Med Pathol. 1997;18(1):75–8.

    Article  PubMed  CAS  Google Scholar 

  20. Waters KA, Gonzalez A, Jean C, Morielli A, Brouillette RT. Face-straight-down and face-near-straight-down positions in healthy, prone-sleeping infants. J Pediatrics. 1996;128(51):616–25.

    Article  CAS  Google Scholar 

  21. Yukawa N, Carter N, Rutty G, Green MA. Intra-alveolar hemorrhage in sudden infant death syndrome: a cause for concern? J Clin Pathol. 1999;52(8):581–7.

    Article  PubMed  CAS  Google Scholar 

  22. Randall BB, Wadee SA, Sens MA, Kinney HC, Folkerth RD, Odendaal HJ, et al. A practical classification schema incorporating consideration of possible asphyxia in cases of sudden unexpected infant death. Forensic Sci Med Pathol. 2009;5(4):254–60.

    Article  PubMed  Google Scholar 

  23. Alm B, Mollborg P, Erdes L, Pettersson R, Aberg N, Norvenius G, et al. SIDS risk factors and factors associated with prone sleeping in Sweden. Arch Disease Childhood. 2006;91(11):915–9.

    Article  CAS  Google Scholar 

  24. Mitchell EA, Ford RP, Stewart AW, Taylor BJ, Becroft DM, Thompson JM, et al. Smoking and the sudden infant death syndrome. Pediatrics. 1993;91(5):893–6.

    PubMed  CAS  Google Scholar 

  25. Lahr MB, Rosenberg KD, Lapidus JA. Bedsharing and maternal smoking in a population-based survey of new mothers. Pediatrics. 2005;116(4):e530–42.

    Article  PubMed  Google Scholar 

  26. Sturner WQ. Some perspectives in ‘cot death’. J Forensic Med. 1971;18(3):96–107.

    PubMed  CAS  Google Scholar 

  27. Stanton AN, Scott DJ, Downham MA. Is overheating a factor in some unexpected infant deaths? Lancet. 1980;1(8177):1054–7.

    Article  PubMed  CAS  Google Scholar 

  28. Bacon C, Scott D, Jones P. Heatstroke in well-wrapped infants. Lancet. 1979;1(8113):422–5.

    Article  PubMed  CAS  Google Scholar 

  29. Hoffman HJ, Hunter JC, Damus K, Pakter J, Peterson DR, van Belle G, et al. Diphtheria-tetanus-pertussis immunization and sudden infant death: results of the National Institute of Child Health and Human Development Cooperative Epidemiological Study of Sudden Infant Death Syndrome risk factors. Pediatrics. 1987;79(4):598–611.

    PubMed  CAS  Google Scholar 

  30. Opdal SH, Rognum TO. Gene variants predisposing to SIDS: current knowledge. Forensic Sci Med Pathol. 2011;7(1):26–36.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Yijiu Chen.

Additional information

D. Zou and Y. Chen contributed equally to this work.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Huang, P., Yu, R., Li, S. et al. Sudden twin infant death on the same day: a case report and review of the literature. Forensic Sci Med Pathol 9, 225–230 (2013). https://doi.org/10.1007/s12024-013-9429-3

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12024-013-9429-3

Keywords

Navigation