Retarded heart growth in the victims of sudden infant death: possible implications for lethal mechanisms

Kelmanson, Igor A.

doi:10.1007/bf01955178

Cited by 10 publications

(7 citation statements)

References 22 publications

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“…It remains part of the standard autopsy protocol that weights are obtained for all major organs, although the clinical significance of organ weights for determining cause of death in this infant population remains uncertain. Previously published studies have examined the relationship of organ weights with specific pathological processes [12,13] but with variable findings [6]. This dataset will allow subsequent comparative studies to be performed and should provide a valuable reference for practising pathologists requiring reference ranges for organ weights derived contemporaneously.…”

Section: Discussionmentioning

confidence: 99%

Reference ranges for organ weights of infants at autopsy: results of >1,000 consecutive cases from a single centre

Pryce

Bamber²,

Ashworth

et al. 2014

BMC Clin Pathol

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BackgroundInfancy is the most common period for childhood death, including both neonatal deaths from obstetric or medical complications and sudden unexpected infant deaths. The weighing of organs at autopsy is an established process and is recommended in current protocols. However, minimal contemporary data is available regarding reference ranges for organ weights of infants.MethodsOrgan weight data for consecutive infant autopsies over a 14 year period performed at a single tertiary centre, including >1,000 cases, were examined in order to provide up to date reference ranges across this age range, using linear regression modelling and the standard LMS method.Results1,525 infant autopsies were analysed, of which 1,190 were subsequently used in the creation of linear regression models prior to performance of the LMS method. Organ weight charts were produced for the 5th, 25th, 50th, 75th and 95th centiles for the heart, lungs, liver, spleen, kidneys, pancreas, thymus gland and adrenal glands.ConclusionThis study provides the largest single centre contemporary dataset of infant autopsies allowing provision of up-to-date ‘normal’ ranges for all major organ weights across this age range.

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Section: Discussionmentioning

confidence: 99%

Reference ranges for organ weights of infants at autopsy: results of >1,000 consecutive cases from a single centre

Pryce

Bamber²,

Ashworth

et al. 2014

BMC Clin Pathol

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“…A diagnosis of “unexplained stillbirth” was therefore made for 16 fetuses, who died suddenly after the 17th gestational week before complete expulsion or retraction from the mother, a diagnosis of “unexplained early neonatal death” for 4 newborns who died between birth and the first 2 postnatal days, and of SIDS for 15 infants who died within the first 10 months of life. In particular, ordinary myocardium lesions (such as muscle fibre necrosis), cardiac conduction system alterations (accessory atrio‐ventricular communications, cartilagineous metaplasia of the fibrous body), positive microbiological findings, decreased heart weight, genetic variants in LQTS genes (long‐QT syndrome), all features frequently reported in SIDS (Kariks, 1988; Matturri et al, 2000; Thiene, 1988; Goldwater, 2009; Kelmanson, 1996; Arnestad et al, 2007), were not found in the 15 cases of sudden infant death of the study. Regarding the infant sleeping position at death, 8 victims were noticed in prone position and 7 in supine position.…”

Section: Methodsmentioning

confidence: 99%

Neuropathology of the intermediolateral nucleus of the spinal cord in sudden unexplained perinatal and infant death

Lavezzi

Corna

Mehboob

et al. 2010

Intl J of Devlp Neuroscience

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Experimental studies have demonstrated that breathing activity in rats is generated early in embryonic stages in rostral spinal cord, precisely in the intermediolateral nucleus, then establishing a spinal cord-brainstem network. In this study we aimed to individuate and to define the developmental steps of the intermediolateral nucleus, still inadequately known in humans, in the thoracic spinal cord of a large series of perinatal and infant death victims, aged from 17 gestational weeks to 10 months of life. Besides we investigated a possible link between alterations of this nucleus and sudden unexplained perinatal and infant death. The normal developmental pattern of the human intermediolateral nucleus consists of a progressive maturation of its neurons, that change from a round to a polygonal shape with long axons and significantly decrease in number. Various degrees of intermediolateral nucleus hypodevelopment (neuronal immaturity in a normal structure/hypoplasia/agenesis) were found almost exclusively in unexplained fetal and infant death victims. Besides, a significant correlation was found between maternal smoking in pregnancy and the neuropathological results. In conclusion this work underlines the negative effects of prenatal nicotine exposure on the development of autonomic nervous centers checking the vital functions, already in early gestational stages, when the integrity of the intermediolateral nucleus is indispensable for the first breathing bursts.

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“…Misleading and inaccurate results are often obtained when comparing heart weight today with that considered normal for a specific age in Plder articles and tables (3,7), as general nutrition and healthcare have changed since the time of those early publications (8). Heart weight is more closely correlated with body weight than with age, and no statistically significant association between heart weight and age at death or gestational death has been found (9).…”

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confidence: 88%

Heart weight in infants—a comparison between Sudden Infant Death Syndrome and other causes of death

2000

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RBsten-Almqvist P, Eksborg S, Rajs J. Heart weight in infants-a comparison between Sudden Infant Death Syndrome and other causes of death. Acta Prediatr 2000; 89: 1062-7. Stockholm.Heart and body weights were compared with regard to heart pathology and cause of death in welldefined groups of infants under I y of age. In the period 1980 to 1998, out of 468 infants autopsied at the Department of Forensic Medicine in Stockholm, Sweden, 331 died of sudden infant death syndrome (SIDS), while 137 died of other causes. Physical violence was the known cause of death in 30 infants and cardiovascular malformations in another 19. Inflammatory alterations of the myocardium were found in 74 cases (16%): in 17 cases (3.6%) myocarditis was interpreted as the main cause of death; in 45 (10%) it was interpreted as contributing to SIDS and in 12 cases (2.5%) it was observed but judged not to be a contributory cause of death in non-SIDS victims. Two of these infants died as a result of physical violence. Body weight was the best predictor for heart weight as analysed by multiple regression, including age, sex, body weight, length, BMI and birth weight. An equation for estimating heart weight from body weight gave an accuracy within the range 0.75-1.25 in 89.2% and 85.0% of the SIDS and non-SIDS groups, respectively.Conclusion: Body weight is the best predictor for estimating heart weight. No evidence supported the notion that heart weight, body weight or birth weight of SIDS victims differs from non-SIDS, although heart weight in infants with cardiovascular malformations deviated from observations in the other groups.

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Retarded heart growth in the victims of sudden infant death: possible implications for lethal mechanisms

Abstract: Retarded heart growth may lead to functional disturbances and may contribute to possible mechanisms in some SID cases.

Cited by 10 publications

References 22 publications

Reference ranges for organ weights of infants at autopsy: results of >1,000 consecutive cases from a single centre

Reference ranges for organ weights of infants at autopsy: results of >1,000 consecutive cases from a single centre

Neuropathology of the intermediolateral nucleus of the spinal cord in sudden unexplained perinatal and infant death

Heart weight in infants—a comparison between Sudden Infant Death Syndrome and other causes of death

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