Abstract
The investigation of sudden death of infants varies, and death rates may depend on local practices of death certification. We studied the extent of the investigation and the final cause of death (COD) in 3 regions: New York, New York, USA (NY); King County, Washington, USA (KC); and Montevideo, Uruguay (MU). We conducted a retrospective review of 543 cases (NY 258, KC 56, MU 229) of previously healthy babies who died suddenly without obvious trauma, at ages 0 to 12 months, over a 3-year period (1998 to 2001). All cases included a complete autopsy and histologic examination. Cases were assessed for completion of special studies (including radiographs, photos, toxicology and metabolic sampling, cultures, and vitreous humor chemistry), measurements, and scene investigation. Specialized pediatric measurements and testing were done less often than routine procedures, and were done less often in cases overall compared with cases certified as sudden infant death syndrome (SIDS). Fifty-five percent of SIDS cases in NYC and 12% of SIDS cases in KC had no scene investigation. Manhattan had a complete workup in 42% of SIDS cases, whereas the remaining sites had fewer that 15% of cases completely worked up. The most common non-natural COD was suffocation at all 3 sites. The overall most common COD were respiratory infection in MU (22%) and SIDS in NY (45%) and KC (86%). We conclude that the sudden death of infants requires special consideration and still lacks consistency. SIDS investigations are not done completely in all cases and rates may depend on regional differences in certifying infant deaths.
Similar content being viewed by others
References
Willinger M, James S, Catz C. Defining the SIDS: deliberations of an expert panel convened by the National Istitute of Child Health and Human Development. Pediatr Pathol 1991;11:677–684
Kroius HF, Byard RW. International standardized autopsy protocol for sudden unexpected infant death. Appendix I. In: Byard RW, Krous HF, eds. Sudden Infant Death Syndrome: Problems, Progress and Possibilities. London: Arnold, 2001;319–333
Centers for Disease Control and Prevention (CDC). Guidelines for death scene investigation of sudden unexplained infant deaths. Recommendations of the Interagency Panel on Sudden Infant Death Syndrome. MMWR 1996;45:1–22
Beckwith JB. Defining the sudden infant death syndrome. Arch Pediatr Adolesc Med 2003;157:286–290
Krous HF, Beckwith JB, Byard RW, et al. Sudden infant death syndrome and unclassified sudden infant deaths: a definitional and diagnostic approach. Pediatrics 2004;114:234–238
Templeman C. Two hundred and fifty-eight cases of suffocation of infants. Edinburgh Med J 1892;38:322–329
Werne JJ, Garrow I. Sudden deaths of infants allegedly due to mechanical suffocation. Am J Pub Health 1947;37:675–687
Hauck FR. Changing epidemiology. In: Byard RW, Krous HF, eds. Sudden Infant Death Syndrome. London: Arnold, 2001;31–57
Grether JK, Schulman J. SIDS and birth weight. J Pediatr 1989;114:561–567
Kraus JF, Borhani NO. Post-neonatal sudden unexplained death in California: a cohort study. Am J Epidemiol 1972;95:497–498
Adelson L, Kinney ER. Sudden and unexpected death in infancy and childhood. Pediatrics 1956;17:663–697
Hoffman HJ, Damus K, Hillman L, Krongrad E. Risk factors for SIDS: results of the NICHD SIDS cooperative epidemiological study. Ann NY Acad Sci 1988;533:13–30
Acknowledgments
The authors greatly appreciate the contribution of Drs. Angeles Rodriguez and Sylvia Palenzuela (Pediatric Pathology), Dr. Cristina Scavone (Pediatric Neurology), Dr. Virginia Kanopa (Pediatrics and Pediatric Neurology), and Dr. Aida Lemes (Metabolic Diseases), Hospital Pereira Rossell, Montevideo, Uruguay. The authors thank Kelly Lenz, MPH, from the office of the Chief Medical Examiner, New York, for statistical analysis.
Author information
Authors and Affiliations
Corresponding author
Additional information
This work was presented in part at the annual meeting of the Society for Pediatric Pathology; Washington, DC; March 22-23, 2003.
Rights and permissions
About this article
Cite this article
Landi, K., Gutierrez, C., Sampson, B. et al. Investigation of the Sudden Death of Infants: A Multicenter Analysis. Pediatr Dev Pathol 8, 630–638 (2005). https://doi.org/10.1007/s10024-005-8095-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10024-005-8095-1