Sudden unexpected infant death syndrome in Ribeirão Preto, Brazil
Keywords:
SIDS, Sudden death, Autopsy, Child deathAbstract
CONTEXT: Sudden Infant Death Syndrome (SIDS) is the leading cause of death in the first year of life in developed countries. Brazilian and Latin American literature lack studies on the subject, which is largely unknown among health workers. OBJECTIVE: To identify cases that could be classified as SIDS among children of less than one year of age submitted to autopsy at the Serviço de Verificação de Óbitos do Interior (SVOI), in Ribeirão Preto, SP, Brazil. A retrospective analysis of all autopsies from SVOI in this age group from January 1987 to December 1990 was done. RESULTS: There were 369 autopsies of which 344 (93.2%) deaths were expected and 25 (6.8%) unexpected. From the 25 unexpected cases 16 (64%) deaths could not be explained after autopsy and from these cases only 10 were eligible for the study because they had full organ sampling. There were 7 males and 3 females and the age at death ranged from 1 to 3 months (average: 1.7 months). Two were found dead, 3 died at home, 4 died on the way to hospital and 1 died while being fed. Autopsy diagnoses were aspiration (8 cases), SIDS (1 case) and undetermined (1 case). Aspiration was not confirmed by histology and the only findings were mild pulmonary edema, subcapsular petechiae and intraparenchymatous hemorrhage in thymus. CONCLUSION: That there were 10 cases of unexpected and unexplained deaths of children less than 1 year-old during the evaluated period with characteristics similar to SIDS which should therefore be classified as such.
Downloads
References
Beckwith JB. Introduction: discussion of terminology. In: Bergman AB, Beckwith JB, Ray CG, editors. Sudden infant death syndrome. Washington DC: University of Washington Press 1970;p.18.
Victora CG, Letícia CN, Lombardi C, et al. Quadro epidemiológico das mortes súbitas na infância em cidades gaúchas (Brasil). Săo Paulo: Ver Saúde Públ 1987;21:490-6.
SICAEV. Sistema de coleta e análise de estatísticas vitais. Ribeirăo Preto, SP: Secretaria Municipal da Saúde, Boletim 1992: I (1).
MMWR. Sudden infant death syndrome - United States, 1983-1994. Morb Mortal Wkly Rep 1996;45:859-63.
Wolf BH, Ikeogu MO. Is sudden infant death syndrome a problem in Zimbabwe? Ann Trop Paediatr 1996;16:149-53.
Tan SY, Lau G. Sudden infant death in a tropical environment: Singapore's experience. Forensic Sci Int 1996;79:11-22.
Willinger M, James LS, Catz C. Defining the sudden infant death syndrome (SIDS): deliberations of an expert panel convened by the National Institute of Child Health and Human Development. Pediatr Pathol 1991;11:677-84.
Guntheroth WG, Spiers P, Naeye RL. Redefinition of the Sudden Infant Death Syndrome: the disadvantages. Pediatr Pathol 1994;14:127-32.
McLaughlin AS, Valdes MG, Jacobsen RM, et al. Incidence of sudden infant death syndrome in Olssted County, Minnesota: 1945 through 1992. Mayo Clinic Proc 1995;70:837-43.
Rodrigues-Alarcon J, Melchor JC, Linares A, et al. Early neonatal death or near-death syndrome. An epidemiological study of 29 cases. Acta Paediatr 1994;83:704-8.
Valdes-Dapena M, Gilbert-Barness, Naeye RL. Sudden infant death syndrome in Potter's pathology of the fetus and infant. In: Barness-Gilbert E, editor. Mosby-Year Book Inc 1997;12:433-52.
Valdes-Dapena M. Sudden and unexpected death in infancy: a review of the world literature. Pediatrics 1967;39(1):123-37.
Valdes-Dapena M. Sudden infant death syndrome: overview of recent research developments from a pediatric pathologist's perspective. Pediatrician 1988;15:222-30.
Berry PJ. Pathological findings in SIDS. J Clin Pathol 1992;45(11 suppl):11-6.
Krous HF. The microscopic distribution of intrathoracic petechiae in sudden infant death syndrome. Arch Pathol Lab Med 1984;108:77-9.
Beckwith JB. Intrathoracic hemorrhages: a clue to the mechanism of death in sudden infant death syndrome? Ann New York Acad Sci 1988;533:37-47.
Valdes-Dapena M, Mc-Feeley PA, Hoffman HJ, et al. Histopathology atlas for the sudden infant death syndrome. Armed Forces Institute of Pathology in cooperation with the American Registry of Pathology and the National Institute of child health and human development. Washington DC: 1993.
Fleming PJ. Understanding and preventing sudden infant death syndrome. Current Opin Pediatr 1994;6:158-62.
Fleming PJ, Blair PS, Bacon C, et al. Environment of infants during sleep and risk of the sudden infant death syndrome: results of 1993-5 case-control study for confidential inquiry into stillbirths and deaths in infancy. Confidential enquiry into stillbirths and deaths: regional coordinators and researches. Brit Med J 1996;313:191-5.
Taylor JA, Krieger JW, Reay DT, et al. Prone sleeping position and the sudden infant death syndrome in King County, Washington: a case-control study. J Pediatr 1996;128:626-30.
Spiers PS, Guntheroth WG. Recommendations to avoid the prone sleeping position and recent statistics for sudden infant death syndrome in the United States. Arch Pediatr Adolesc Med 1994;148:141-6.
Willinger M. SIDS prevention. Pediatr Ann 1995;24:358-64.
Irgens LM, Markestad T, Baste V, et al. Sleeping position and sudden infant death syndrome in Norway 1967-1991. Arch Dis Child 1995;72:478-82.
Wigfield RE, Fleming PJ, Berry PJ, et al. Can the fall in Avon's sudden infant death rate be explained by changes in sleeping position? Brit Med J 1992;304:282-3.
Faure C. Position and sudden infant death of the infant (editorial). Presse Med 1995;24:1879-81.
