scholarly journals Ten Percent of SIDS Cases are Murder — or are They?

2017 ◽  
Vol 7 (2) ◽  
pp. 163-170 ◽  
Author(s):  
Christopher M. Milroy ◽  
Charis Kepron
Keyword(s):  
Sudden Infant Death ◽  
Current Data ◽  
Related Question ◽  
Sudden Infant ◽  
Court Cases ◽  
Unexpected Death ◽  
Infant Deaths ◽  
Lower Figure ◽  
History Of ◽  
Made In

Sudden infant death syndrome (SIDS) has been used as a cause of death for over four decades. It has allowed deaths of infants to be registered as natural. Within this group of deaths, a certain number have been recognized to be homicides from inflicted smothering rather than being natural or accidental deaths. Research has been conducted using confidential inquires to determine how frequent homicide is in cases called SIDS. This paper traces the history of quoted rates of homicide. Early work suggested the figure was between 2-10% of all SIDS cases, though other workers have suggested figures as high as 20-40%. With the fall in the rate of infant deaths following the “Back to Sleep” campaigns, these figures have been reevaluated. If the higher figures were correct that 20-40% of SIDS were homicides, the fall in infant deaths would be expected to be less than it has been. Current data suggests a much lower figure than 10% of current cases, with much lower overall rates of infant deaths. As well as 10% of SIDS cases having been stated to be homicides, a related question is whether multiple deaths classified as SIDS are really homicides. The paper discusses the maxim that one death is a tragedy, two is suspicious, and three deaths indicate homicide. The paper also looks at court cases and the approach that has been made in prosecutions of sudden unexpected death in infancy as multiple murder.

Sudden Infant Death Syndrome (SIDS) in Denmark: Evaluation of the Increasing Incidence of Registered SIDS in the Period 1972 to 1983 and Results of a Prospective Study in 1987 through 1988

PEDIATRICS ◽  
1992 ◽  
Vol 89 (5) ◽  
pp. 855-859
Author(s):  
Karin Helweg-Larsen ◽  
Lisbeth B. Knudsen ◽  
Markil Gregersen ◽  
Jørn Simonsen
Keyword(s):  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Respiratory Infections ◽  
Sudden Infant Death ◽  
Epidemiological Studies ◽  
Sudden Infant ◽  
Unexpected Death ◽  
National Board ◽  
Infant Deaths ◽  
Live Births

To investigate a reported increase, from 0.4 to 1.3 per thousand live births, in the Danish incidence of sudden infant death syndrome (SIDS), a retrospective analysis of SIDS in Denmark from 1972 to 1983 was carried out. Based on data registered with the National Board of Health, a notable regional difference in SIDS rate between the western and eastern parts of Denmark was found. This difference did not correlate with the overall postneonatal mortality by region. Danish law requires medicolegal investigation in all cases of sudden unexpected death. Medicolegal autopsies are performed only in the three forensic institutes which cover all of Denmark. Despite the law and a uniform organization of the forensic medical services, differing application of postmortem examinations and individual interpretation of the history and autopsy in cases of sudden infant death existed. Differences in reporting of respiratory infections, suffocation, and cardiac malformation were found to contribute to the increase and to regional disparities in SIDS incidence. The three Danish forensic institutes examined all cases of sudden infant deaths in Denmark 1987 and 1988. These cases were classified as explained cause of death, pure SIDS, and atypical SIDS; atypical cases were evaluated by consensus. The SIDS incidence (the number of classic SIDS and atypical SIDS per thousand live births) was 1.9 in 1987 and 1.3 in 1988, and it was identical in the eastern and western part of Denmark; however, a higher incidence both of overall postneonatal and SIDS mortality was found in the middle region of Denmark. The analysis stresses the importance of high autopsy rate and expert investigation in all cases of infant death in order to obtain reliable data for epidemiological studies. A prospective joint study of all postneonatal infant deaths in Finland, Iceland, Norway, Sweden, and Denmark will be carried out to analyze the reliability and the possible cause of reported differences in SIDS incidence in the five Nordic countries.

scholarly journals Mortality of babies enrolled in a community-based support programme: CONI PLUS (Care of Next Infant Plus)

2015 ◽  
Vol 100 (7) ◽  
pp. 637-642 ◽  
Author(s):  
Alison J Waite ◽  
Robert C Coombs ◽  
Angela McKenzie ◽  
Charlotte Daman-Willems ◽  
Marta C Cohen ◽  
...  
Keyword(s):  
Extended Family ◽  
Sudden Infant Death ◽  
Sudden Infant ◽  
Unexpected Death ◽  
Community Based ◽  
Support Programme ◽  
Life Threatening ◽  
History Of ◽  
The Uk ◽  
Age Range

ObjectiveTo report mortality in babies enrolled on a community-based programme, Care of Next Infant Plus (CONI PLUS), which primarily supports parents anxious because of previous sudden unexpected death in infancy (SUDI) in their extended family or following an apparent life threatening event (ALTE) in their baby.DesignProspective observational study from 1996 to 2010 in the UK.ResultsOf 6487 babies enrolled, 37 died (5.7 per 1000). There were 2789 (43.0%) SUDI related babies of whom, six died suddenly and unexpectedly (2.15 per 1000). Four babies were sharing a sofa at night or a bed with parent(s) who smoked or had consumed alcohol. Of the 1882 (29.0%) babies enrolled following an ALTE, five died suddenly and unexpectedly (2.66 per 1000): four unexplained and one due to infection. None occurred while sharing a sleep surface, and at least three died during the day. The remaining 1816 (28%) babies were enrolled for other reasons. Seven died suddenly and unexpectedly (3.85 per 1000), two were unexplained and none associated with bed sharing.ConclusionsThe number of SUDI deaths in babies enrolled on CONI PLUS is higher than expected from UK averages. Deaths in babies enrolled because of family history of SUDI were mostly associated with inappropriate sharing of a sleep surface at night and mostly outside the peak age range for sudden infant death. The opposite is true for those enrolled following an ALTE. The number of deaths is small but findings suggest a different mechanism for death in these two groups.

An Epidemiological and Sociological Study of Unexpected Death in Infancy in Nine Areas of Southern England

1981 ◽  
Vol 21 (2) ◽  
pp. 89-98 ◽  
Author(s):  
Elizabeth Watson ◽  
Angela Gardner ◽  
R. G. Carpenter
Keyword(s):  
Sudden Infant Death ◽  
Service Planning ◽  
Child Health Service ◽  
Sudden Infant ◽  
Sociological Study ◽  
Unexpected Death ◽  
Simple Method ◽  
Infant Deaths ◽  
Future Child ◽  
Use Of Medical Services

Similar histories of illness were recorded in the three weeks prior to death for children who died unexpectedly in infancy and for live controls in the three weeks prior to interview. Symptom analysis showed that the main difference between the two groups of children was the non-specific behavioural changes manifested in the case infants shortly before death. Underestimation of the severity of symptoms by parents or medical attendants was indicated in a proportion of the cases in all areas. Use of medical services was shown to vary widely between areas with a marked tendency to use hospital rather than general practitioner services in the inner city. The investigation into sudden infant death in one area included periodic progress meetings where possible preventable causes of the deaths were examined and future child health service planning decided in the light of the knowledge gained. Since the study began, the number of sudden infant deaths in this area has dropped significantly. It is suggested that such an enquiry into the circumstances at each death would be a simple method of undertaking a study of sudden death in a locality and possibly lowering the incidence.

Sudden Unexpected Death in Childhood: A Report of 50 Cases

2005 ◽  
Vol 8 (3) ◽  
pp. 307-319 ◽  
Author(s):  
Henry F Krous ◽  
Amy E. Chadwick ◽  
Laura Crandall ◽  
Julie M. Nadeau-Manning
Keyword(s):  
Family History ◽  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Sudden Infant Death ◽  
Postmortem Examination ◽  
Sudden Unexpected Death ◽  
Sudden Infant ◽  
Unexpected Death ◽  
Live Births ◽  
History Of

Sudden unexplained death in childhood (SUDC) is rare, with a reported incidence in the United States of 1.5 deaths per 100,000 live births compared with 56 deaths per 100,000 live births for sudden infant death syndrome in 2001. The objectives of this study include a proposal for a general definition for SUDC and presentation of 36 cases of SUDC and 14 cases of sudden unexpected death in childhood. Cases were accrued through referrals or unsolicited via our Web page ( www.sudc.org ). Our analyses tentatively suggest a SUDC profile characterized by cases being 1 to 3 years in age, predominantly male, and frequently having a personal and family history of seizures that are often associated with a fever. A history of recent minor head trauma is not uncommon. They are usually born at term as singletons and occasionally have a family history of sudden infant death syndrome or SUDC. Most are found prone, often with their face straight down into the sleep surface. Minor findings are commonly seen at postmortem examination but do not explain their deaths. Comprehensive review of the medical history and circumstances of death and performance of a complete postmortem examination including ancillary studies and extensive histologic sampling of the brain are critical in determining the cause of death in these cases of sudden unexpected childhood death. Legislation enabling research and formation of a multicenter research team is recommended to unravel the mystery of SUDC.

Cosleeping and Sudden Unexpected Death in Infancy

2002 ◽  
Vol 126 (3) ◽  
pp. 343-345
Author(s):  
Tiffany L. A. Person ◽  
Wendy A. Lavezzi ◽  
Barbara C. Wolf
Keyword(s):  
Sudden Infant Death Syndrome ◽  
Sudden Infant Death ◽  
Sudden Unexpected Death ◽  
Sudden Infant ◽  
Unexpected Death ◽  
Infant Deaths ◽  
The Subject ◽  
Bedding Materials ◽  
Mechanical Asphyxia

Abstract Context.—The practice of infants cosleeping with adults has long been the subject of controversy. Autopsy findings in cases of sudden infant death syndrome (SIDS) are usually indistinguishable from those found with unintentional or intentional suffocation, and the determination of the cause of death in cases of sudden unexpected death in infancy is often based on investigative findings and the exclusion of natural or traumatic causes. Objective.—To further elucidate the risk of cosleeping. Methods.—We reviewed 58 cases of sudden unexpected infant deaths. Cases were excluded if there was any significant medical history or evidence of trauma or abuse. Results.—Twenty-seven of the infants were cosleeping. Eleven of these cases had been previously diagnosed as SIDS, and in 7 cases parental intoxication was documented. Conclusion.—Our findings support recent studies that suggest that cosleeping or placing an infant in an adult bed is a potentially dangerous practice. The frequency of cosleeping among cases diagnosed as SIDS in our study suggests that some of these deaths may actually be caused by mechanical asphyxia due to unintentional suffocation by the cosleeping adult and/or compressible bedding materials.

scholarly journals SIDS: EPIDEMIOLOGY, INFANT PHYSIOLOGY AND SALIVA ASPIRATION

2017 ◽  
Vol 5 ◽  
pp. 948-952
Author(s):  
Sigitas Chmieliauskas ◽  
Sigitas Laima ◽  
Karolina GinÄŤienÄ— ◽  
Gerda AndriuškeviÄŤiĹ«tÄ— ◽  
Meda SutkeviÄŤiĹ«tÄ— ◽  
...  
Keyword(s):  
Sudden Infant Death ◽  
Sudden Infant ◽  
Serous Fluid ◽  
Unexpected Death ◽  
Infant Deaths ◽  
Medicine Service ◽  
Salivary Gland Secretion ◽  
Wide Range ◽  
Swallowing Reflex ◽  
Histological Results

A sudden infant death syndrome (SIDS) is diagnosed in the case of a sudden and unexpected death of an infant during sleep and where an autopsy shows no obvious pathological lesions or injuries. Although literature indicates a wide range of risk factors, there is no single opinion on the specific cause of SIDS. This paper describes a study of 191 infant deaths in which the State Forensic Medicine Service established 29 SIDS cases. Microscopical and histological results of samples taken from sections of the respiratory system reveal serous fluid in the alveoli and change specific to asphyxia in all autopsy cases of infants diagnosed with SIDS. The risk of SIDS is highest in infants aged 1–4 months. Salivary gland secretion increases with the development of infant physiology, and this increase coincides with infant teething. However, in this phase, an infant’s swallowing reflex is still to form completely. Findings suggest that the serous fluid found in the alveoli was from the salivary glands, and thus, saliva aspiration may be associated with infant deaths due to SIDS.

Sudden unexpected death in infancy: aetiology, pathophysiology, epidemiology and prevention in 2015

2015 ◽  
Vol 100 (10) ◽  
pp. 984-988 ◽  
Author(s):  
Peter J Fleming ◽  
Peter S Blair ◽  
Anna Pease
Keyword(s):  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Sudden Infant Death ◽  
Current Understanding ◽  
Sudden Unexpected Death ◽  
Sudden Infant ◽  
Unexpected Death ◽  
Infant Deaths ◽  
The Uk ◽  
Review Current

Despite the fall in numbers of unexpected infant deaths that followed the ‘Back to Sleep’ campaigns in the early 1990s in the UK and many other countries, such deaths remain one of the largest single groups of deaths in the postneonatal period in many Western countries. Changes in the ways in which unexpected infant deaths are categorised by pathologists and coroners, and increasing reluctance to use the term ‘sudden infant death syndrome’, make assessment of nationally and internationally collected data on incidence potentially inaccurate and confusing. In this paper, we review current understanding of the epidemiology and aetiology of unexpected deaths in infancy, and current hypotheses on the pathophysiology of the processes that may lead to death. We also review interventions that have been adopted, with variable degrees of effectiveness in efforts to reduce the numbers of deaths, and new approaches that offer the possibility of prevention in the future.

scholarly journals Aquaporin-1 and aquaporin-9 gene variations in sudden infant death syndrome

2021 ◽  
Author(s):  
Siri Hauge Opdal ◽  
Linda Ferrante ◽  
Torleiv Ole Rognum ◽  
Arne Stray-Pedersen
Keyword(s):  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Brain Function ◽  
Sudden Infant Death ◽  
Sudden Infant ◽  
Unexpected Death ◽  
Aquaporin 9 ◽  
Genes Encoding ◽  
External Risk ◽  
The Brain

AbstractSeveral studies have indicated that a vulnerability in the development and regulation of brain function is involved in sudden infant death syndrome (SIDS). The aim of this study was to investigate the genes encoding the brain aquaporins (AQPs) AQP1 and AQP9 in SIDS. The hypothesis was that specific variants of these genes are part of the genetic vulnerability predisposing infants to sudden unexpected death. The study included 168 SIDS cases with a median age of 15.5 (range 2–52) weeks and 372 adolescent/adult deceased controls with a median age of 44 (range 11–91) years. In the AQP1 gene, the rs17159702 CC/CT genotypes were found to be associated with SIDS (p = 0.02). In the AQP9 gene, the combination of a TT genotype of rs8042354, rs2292711 and rs13329178 was more frequent in SIDS cases than in controls (p = 0.03). In the SIDS group, an association was found between genetic variations in the AQP1 gene and maternal smoking and between the 3xTT combination in the AQP9 gene and being found lifeless in a prone position. In conclusion, this study adds further evidence to the involvement of brain aquaporins in SIDS, suggesting that specific variants of AQP genes constitute a genetic predisposition, making the infant vulnerable to sudden death together with external risk factors and probably other genetic factors.

Postmortem genetic analysis of sudden unexpected death in infancy: neonatal genetic screening may enable the prevention of sudden infant death

2017 ◽  
Vol 62 (11) ◽  
pp. 989-995 ◽  
Author(s):  
Yuki Oshima ◽  
Takuma Yamamoto ◽  
Taisuke Ishikawa ◽  
Hiroyuki Mishima ◽  
Aya Matsusue ◽  
...  
Keyword(s):  
Genetic Analysis ◽  
Infant Death ◽  
Genetic Screening ◽  
Sudden Infant Death ◽  
Sudden Unexpected Death ◽  
Sudden Infant ◽  
Unexpected Death

scholarly journals An Approach to the Classification of Apparent Asphyxial Infant Deaths

2017 ◽  
Vol 7 (2) ◽  
pp. 200-211 ◽  
Author(s):  
Evan W. Matshes ◽  
Emma O. Lew
Keyword(s):  
Risk Factors ◽  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Sudden Infant Death ◽  
Sudden Infant ◽  
Death Certification ◽  
High Quality ◽  
Infant Deaths ◽  
Unexpected Infant Death

Recent evidence indicates that with thorough, high quality death investigations and autopsies, forensic pathologists have recognized that many unexpected infant deaths are, in fact, asphyxial in nature. With this recognition has come a commensurate decrease in, and in some cases, abolition of, the label “sudden infant death syndrome” (SIDS). Current controversies often pertain to how and why some infant deaths are determined to be asphyxial in nature and whether or not apparent asphyxial circumstances are risk factors for SIDS, or rather, harbingers of asphyxial deaths. In an effort to sidestep these controversies, some forensic pathologists elected to instead use the noncommittal label “sudden unexpected infant death” (SUID), leading to the unfortunate consequence of SUID – like SIDS – gaining notoriety as an actual disease that could be diagnosed, studied, and ultimately cured. Although it is not possible to provide death certification guidance for every conceivable type of unexpected infant death, we recognize and propose a simple classification system for overarching themes that cover the vast majority of cases where infants die suddenly and unexpectedly.

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