Sudden Infant Death Syndrome: Postmortem Investigation and Risk Factors

Abstract

Sudden infant death syndrome (SIDS) is the largest single “category” of sudden unexpected death in infancy (SUDI) in babies over 1 month old in developed countries. SIDS is defined as 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 review of the clinical history. SIDS is, consequently, a diagnosis by exclusion and the result of a “negative” postmortem. The investigation of any case of SUDI is best conducted using a multidisciplinary approach. Only when the recognized causes of death are excluded is it appropriate to label the death as due to SIDS. In addition, it is best to arrive at this conclusion after a multidisciplinary inquiry. As data accumulates, the percentage of cases ascribed to SIDS diminishes.

Diabetes Related Deaths in a Tertiary Pediatric Referral Institution in England: The Value of Biochemical Analyses in Post-Mortem Samples

“…Frozen tissue for lipid stains using Oil Red O stain (ORO) and eventual molecular studies is taken from: heart, liver, kidney, and skeletal muscle (stored frozen at −80°C). [21][22][23][24] All SUDI and SUDC cases are investigated following the Kennedy protocol, which is the result of a working group convened by The Royal College of Pathologists and endorsed by The Royal College of Paediatrics and Child Health, chaired by the Baroness Helena Kennedy QC. 25 The Kennedy Protocol also guides other aspects pf the investigation, such as gathering clinical and family history, home visit (conducted jointly by a pediatrician and the police, both trained in these investigations), and a final multidisciplinary meeting to discuss the cause of death: chaired by a pediatrician, and with the attendance of the pathologist, police, ambulance team, emergency team involved in the resuscitation, general practitioner, etc.…”