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Open Access 01-08-2020 | Autopsy | Original Article

A standardized postmortem protocol to assess the real burden of sudden infant death syndrome

Authors: Stefania Rizzo, Monica De Gaspari, Elisa Carturan, Beatrice Paradiso, Donata Favretto, Gaetano Thiene, Cristina Basso

Published in: Virchows Archiv | Issue 2/2020

Abstract

Sudden unexpected infant death (SUID) is a major cause of death in infants < 1 year of age. Sudden infant death syndrome (SIDS) is a SUID still unexplained after post-mortem examination. In 2014, a protocol of post-mortem investigation was introduced to assess both the prevalence and the etiopathogenesis of SUID. Our aim was to compare SUID data before and after the application of a standardized autopsy protocol of investigation. In the time interval 2004–2018, SUID cases occurring in the Veneto Region, North-East Italy, were referred to our Core Lab. Since 2014, a complete autopsy was performed, including gross and histological study with toxicologic and molecular analysis carried out at the referral center. A total of 36 SUIDs (22 M, mean age 95.5 ± 80 days), 17 before (group A) and 19 after (group B) 2014, were collected. In group A, only 1 (6%) resulted as explained SUID, due to lymphocytic myocarditis and 16 (94%) were SIDS. In group B, 8 were SIDS (42%) and 11 (58%) explained SUID cases (p < 0.01), consisting of interstitial pneumonia and bronchiolitis in 9 and lymphocytic myocarditis in 2 cases. Molecular analysis was positive for viruses in 8 of them (73%). In conclusion, since the application of a standardized protocol of post-mortem investigation, inflammatory, mostly infective, cardio-pulmonary diseases have been identified as the most common cause of SUID, with SIDS falling from 94 to 42% of SUID. Efforts must be made to implement a uniform autopsy protocol to provide reliable epidemiological data on SIDS.

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Title: A standardized postmortem protocol to assess the real burden of sudden infant death syndrome
Authors: Stefania Rizzo
Monica De Gaspari
Elisa Carturan
Beatrice Paradiso
Donata Favretto
Gaetano Thiene
Cristina Basso
Publication date: 01-08-2020
Publisher: Springer Berlin Heidelberg
Keywords: Autopsy
Myocarditis
Sudden Infant Death Syndrome
Published in: Virchows Archiv / Issue 2/2020
Print ISSN: 0945-6317
Electronic ISSN: 1432-2307
DOI: https://doi.org/10.1007/s00428-020-02747-2

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A standardized postmortem protocol to assess the real burden of sudden infant death syndrome

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