Abstract
Sudden Infant Death Syndrome (SIDS) has been reported to be the leading cause of death in infants under 1 year of age in many countries. Unfortunately, a paucity of published research data exists in South Africa, with regard to the incidence of and investigation into the circumstances surrounding Sudden Unexplained Deaths in Infants (SUDI) and/or SIDS. Currently, even though most academic centers conform to a protocol consistent with internationally accepted standards, there exists no nationally accepted infant death investigation protocol in South Africa. It is the aim of this study to review the current practice of infant death investigation in two representative but geographically and demographically distinct centers. Retrospective case audit over a five-year period (2000–2004) was conducted at two large medico-legal mortuaries in Pretoria (Gauteng) and Tygerberg (Cape Town). Case files on all infants younger than 1 year of age were reviewed. The outcome measures included number of deaths, demographic details and the nature and final outcome of the post mortem examinations. A total of 512 cases were identified as possible SIDS cases and of these, 171 was classified as SIDS. The study showed marked inter-case and inter-divisional variation in terms of the investigation of infant deaths at the two institutions. It is envisaged that this study will focus attention on the current lack of usable data regarding sudden/unexplained/unexpected infant deaths in South Africa, and aid in the formulation and implementation of a practical (yet internationally accountable) infant death investigation protocol, which could facilitate comparisons with other countries and initiate further structured research in this field.
Similar content being viewed by others
References
Hauck FR, Tanabe KO. International trends in sudden infant death syndrome: stabilization of rates requires further action. Pediatrics. 2008;122:660–6.
Krous HF, Beckwith JB, Byard RW, et al. Sudden infant death syndrome and unclassified sudden infant deaths: a definitional and diagnostic approach. Pediatrics. 2004;114:234–8.
Howatson AG. The autopsy for sudden unexpected death in infancy. Curr Diagn Pathol. 2006;12:173–83.
Krous HF, Byard RW. International standardized autopsy protocol for sudden unexpected infant deaths: appendix I. In: Byard RW, Krous HF, editors. Sudden infant death syndrome: problems, progress and possibilities. London, UK: Arnold; 2001. p. 319–33.
Corey TS, Hanzlik R, Howard J, et al. A functional approach to sudden unexplained infant deaths. Am J Forensic Med Pathol. 2007;28(3):271–7.
Sadler DW. The value of a thorough protocol in the investigation of sudden infant deaths. J Clin Pathol. 1998;51:689–94.
Iyasu S, Rowley D, Hanzlik R. Guidelines for death scene investigation of sudden, unexplained infant deaths: recommendations of the inter-agency panel on sudden infant death syndrome. MMWR Morb Mortal Wkly Rep. 1996;45:1–6.
Pasquale-Styles MA, Tackitt PL, Schmidt CJ. Infant death scene investigation, the assessment of potential risk factors for asphyxia: a review of 209 suddden unexpected infant deaths. J Forensic Sci. 2007;52(4):924–9.
Rambaud C, Guilbert M, Briand E, et al. Microbiology in sudden infant death syndrome (SIDS) and other childhood deaths. FEMS Immunol Med Microbiol. 1999;25:59–66.
Fernandez-Rodriquez A, Ballesteros S, De Ory F, et al. Virological analysis in the diagnosis of suddem children death: a medico-lagal approach. Forensic Sci Int. 2006;161:8–14.
Bajanowski T, Vege A, Byard RW, et al. Sudden infant death syndrome (SIDS)—standardised investigations and classifications: recommendations. Forensic Sci Int. 2007;165:129–43.
Pakis I, Karapirli M, Karayel F, et al. Quality assessment of perinatal and infant post-mortem examinations in Turkey. J Forensic Sci. 2008;53(5):1166–8.
Sharma BR. Sudden infant death syndrome—a subject of medicolegal research. Am J Forensic Med Pathol. 2007;28(1):69–72.
Randall BB, Wadee SA, Sens MA, Kinney HC, Folkerth RD, Odendaal HJ, Dempers JJ. A practical classification schema incorporating consideration of possible asphyxia in cases of sudden unexpected infant death. Forensic Sci Med Pathol. 2009;5:254–60.
Krous HF, Nadeau JM, Silva PD, Blackbourne BD. A comparison of respiratory symptoms and inflammation in sudden infant death syndrome and in accidental or inflicted infant death. Am J Forensic Med Pathol. 2003;24(1):1–8.
www.statssa.gov.za (Publications P03022009).
Mortality and causes of death in South Africa, 2006: Findings from death notification. P0309.0. Publication from Statssa.
Acknowledgments
We would like to thank Prof PJ Becker from the Biostatistics Unit at the MRC in Pretoria for the statistical analysis of the data.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
du Toit-Prinsloo, L., Dempers, J.J., Wadee, S.A. et al. The medico-legal investigation of sudden, unexpected and/or unexplained infant deaths in South Africa: where are we—and where are we going?. Forensic Sci Med Pathol 7, 14–20 (2011). https://doi.org/10.1007/s12024-010-9184-7
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12024-010-9184-7