scholarly journals Medical, Forensic and Social Quandaries of Sudden Infant Death Syndrome Today

Author(s):  
Tatiana Iov ◽  
◽  
Cristina Furnică ◽  
Sofia Mihaela David ◽  
Diana Bulgaru-Iliescu ◽  
...  

Sudden Infant Death Syndrome (SIDS) is described as the sudden, unexplained death (with no attributable cause, during sleep) of a seemingly healthy child before reaching the first year of life. Statistically, SIDS is recognized today as a leading cause of death in infants aged 1 to 12 months. In the present article the authors have analyzed known risk factors, classifications and current standards of forensic investigation while highlighting the necessity of detailed clinical history, autopsy, scene of death examination and lab findings (radiology, metabolic anomalies, infectious diseases and toxicology) in SIDS diagnosis. For an infant death to be considered SIDS, all other possible causes of death must be first excluded, the diagnosis requiring detailed collection and analysis of antemortem patient data and a complete autopsy. Although the forensic methods of today are more exact, the distinction between SIDS and other causes of death (e.g. unintentional asphyxiation, infanticide) remains very difficult in some cases.

PEDIATRICS ◽  
1986 ◽  
Vol 78 (1) ◽  
pp. 146-150
Author(s):  
A. Kahn ◽  
D. Blum ◽  
M. F. Muller ◽  
L. Montauk ◽  
A. Bochner ◽  
...  

To determine possible characteristics of infant victims of sudden death, we examined 114 items related to the pre- and postnatal histories of 42 pairs of twins one of whom died of sudden infant death syndrome (SIDS) leaving a surviving sibling. Interviews with the parents were conducted after the occurrence of SIDS, and the data were checked with records held by gynecologists and pediatricians. To evaluate the specificity of any factors, we studied a control group of 42 age- and sex-matched pairs of twins, both of whom survived the first year of life. Only 11 of 114 characteristics were significantly related to SIDS: future victims had a smaller weight and height at birth, stayed longer in the nursery, and followed a moving object with their eyes, had head control, and smiled at a later age than their surviving siblings. They also fatigued more often during feeding (11/42) and had reduced arm and neck tonus (9/42). They were described as longer sleepers than their surviving siblings. During sleep, some SIDS twins, but no surviving twin, were found to be cyanotic at least once or pale (4/42) and were repeatedly covered with abundant sweat (8/42). In the control group of normal twins, the occurrence of most of these characteristics was found with a frequency comparable to that seen in the SIDS infants; the specificity of these characteristics is thus considered doubtful. The mean birth weight and height were significantly greater in the control group, and no control infant had an episode of cyanosis or pallor or repeated episodes of profuse sweating observed during their sleep. It is concluded that, if further research validates the occurrence of night hyperhydrosis in some future SIDS victims, this symptom could be a clinical risk factor.


PEDIATRICS ◽  
1983 ◽  
Vol 71 (1) ◽  
pp. 49-52 ◽  
Author(s):  
André Kahn ◽  
Jalil Riazi ◽  
Denise Blum

To gain insight into the role of the vagus nerve in sudden infant death syndrome (SIDS), 180 infants ranging in age from 1 to 66 weeks were examined with respect to cardiac response to ocular compression. There were 35 near-miss infants, 76 normal siblings of SIDS victims, and 69 normal control infants. Asystoles within the control group ranged from 0.3 to 1.8 seconds. Ten of 35 (28%) near-miss infants and 10/76 (13%) siblings had asystoles >2.0 seconds when first tested. When statistically compared, the near-miss infants were significantly different from both the control infants and the siblings (Kruskal-Wallis procedure: P < .01, and P < .05, respectively). It is concluded that in the first year of life a significant number of near-miss infants have an exaggerated cardiac response to ocular compression. Furthermore, the presence of prolonged asystoles in certain siblings indicates that vagal hypersensitivity, as manifested by ocular compression, may be, in part, hereditary.


1999 ◽  
Vol 25 (1-2) ◽  
pp. 51-58 ◽  
Author(s):  
C.Caroline Blackwell ◽  
Doris A.C. MacKenzie ◽  
Valerie S. James ◽  
Robert A. Elton ◽  
Abdulaziz A. Zorgani ◽  
...  

PEDIATRICS ◽  
1972 ◽  
Vol 49 (6) ◽  
pp. 860-870
Author(s):  
Abraham B. Bergman ◽  
C. George Ray ◽  
Margaret A. Pomeroy ◽  
Patricia W. Wahl ◽  
J. Bruce Beckwith

Excluding the first week of life, sudden infant death syndrome (SIDS) is the greatest single cause of death during the first year of life and second only to accidents as the greatest killer of children under age 15. All cases of SIDS occurring in King County, Washington (170) during a 44-month period were studied. Birth certificate data from all children born in the county during the same period were utilized for comparison. Findings include a characteristic age distribution (peak at 2 to 3 months), preponderance in males, low birth weight babies, and in lower socioeconomic class families. "Seasonality" and apparent "time clustering" were present in the infants. All SIDS infants died during sleep in a silent fashion. Forty-four percent of the babies had an upper respiratory infection in the 2-week period prior to death. The epidemiologic findings point to viral infection as playing a major contributory role in SIDS.


PEDIATRICS ◽  
1979 ◽  
Vol 63 (1) ◽  
pp. 18-23 ◽  
Author(s):  
Adrian Williams ◽  
Gordon Vawter ◽  
Lynne Reid

It has recently become apparent that some victims of sudden infant death synclrome (SIDS) are chronically hypoxemic before death. In this study, the structural alterations in the pulmonary circulation of 15 victims of SIDS were examined using precise quantitative morphometric techniques applied to the injected and inflated lung. Increased muscularity of the pulmonary circulation has been demonstrated, as evidenced by the extension of muscle into arteries not usually muscularized during the first year of life, and by an increased thickness of the medial wall in some patients. This confirms the findings of Naeye and further justifies the shift of investigative efforts from the events immediately surrounding death to a search for chronic abnormalities.


PEDIATRICS ◽  
1990 ◽  
Vol 86 (4) ◽  
pp. 535-540
Author(s):  
Marc G. Bulterys ◽  
Sander Greenland ◽  
Jess F. Kraus

To investigate the hypothesis that chronic fetal hypoxia contributes to the etiology of sudden infant death syndrome (SIDS), a possible interaction between the effect of maternal cigarette smoking and low hematocrit during pregnancy on the risk of SIDS was studied using the US Collaborative Perinatal Project cohort. The 193 SIDS cases identified in the cohort were analyzed with 1930 controls randomly selected from infants who survived the first year of life. After adjustment for maternal age, infants born to mothers who smoked 10 or more cigarettes per day and who were anemic (hematocrit less than 30%) during pregnancy were at a much higher risk of SIDS than infants born to mothers who did not smoke and were not anemic (odds ratio = 4.0; 95% confidence limits, 2.1 and 7.4). Smoking 10 or more cigarettes per day vs none increased the risk of SIDS by 70% among women with hematocrit at or above 30% but increased risk threefold among women with hematocrit below 30%. After adjustment for more potential confounders in a logistic regression model, the effect of smoking on SIDS continued to increase with lower levels of hematocrit during pregnancy. Birth weight accounted for very little of these associations. Low hematocrit was not a risk factor for SIDS among nonsmokers but became an important predictor among heavy smokers. These findings are in agreement with the hypothesis that chronic fetal hypoxia may predispose to SIDS, possibly by impairing the normal development of the fetal central nervous system.


2020 ◽  
pp. 35-36
Author(s):  
Sheryl Yanger

Sudden infant death syndrome (SIDS) is the third leading cause of infant mortality in the United States. SIDS is defined as the sudden death of an infant younger than age 1 year that cannot be explained after a thorough investigation, including autopsy, scene investigation, and clinical history. Despite research and advances in understanding of SIDS, it remains a diagnosis of exclusion after ruling out accidental causes such as suffocation/strangulation and cardiac, infectious, metabolic, or traumatic etiologies. Although the exact pathogenesis is unknown, a working model of SIDS includes a combination of exogenous factors, such as overbundling, prone sleep position, and airway obstruction, and intrinsic factors such as immature cardiorespiratory or arousal systems.


PEDIATRICS ◽  
1994 ◽  
Vol 94 (1) ◽  
pp. 124-126 ◽  
Author(s):  

Public and professional awareness of sudden infant death syndrome (SIDS) has increased in the 28 years since the establishment of the National Sudden Infant Death Foundation, now called the National SIDS Alliance.1 Similarly, awareness of child abuse has increased in the 30 years since the publication of the first article on the battered child.2 In the majority of cases, when an infant younger than 1 year dies suddenly and unexpectedly, the cause is SIDS. Sudden infant death syndrome is far more common than infanticide. In a few difficult cases, legitimate investigations for possible child abuse have resulted in an insensitive approach to grieving parents or caretakers. This statement provides professionals with information and guidelines to avoid distressing or stigmatizing families of SIDS victims while allowing accumulation of appropriate evidence in the uncommon case of death by infanticide. INCIDENCE AND EPIDEMIOLOGY Sudden infant death syndrome, also called crib or cot death, is "the sudden death of an infant under 1 year of age which remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene, and a review of the clinical history." 3 Sudden infant death is the most common cause of death between I and 12 months of age. Eighty percent of cases occur before age 5 months, with a peak incidence between 2 and 4 months of age. Sudden infant death syndrome occurs in 1.5 to 2 per 1000 live births, resulting in 6000 to 7000 infant deaths each year in the United States.4


1979 ◽  
Vol 71 (2) ◽  
pp. 219-223 ◽  
Author(s):  
Thomas A. Blumenfeld ◽  
Cary H. Mantell ◽  
Robert L. Catherman ◽  
William A. Blanc

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