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Sudden Unexpected Death in Infancy (Analysis of 34 Cases Including 13 Autopsies)

Journal of the Korean Pediatric Society 2002;45(9):1065-1074.
Published online September 15, 2002.
Sudden Unexpected Death in Infancy (Analysis of 34 Cases Including 13 Autopsies)
Yeo Ok Moon1, Hee Kyoung Choi1, Jeoung-A Her1, Woo Jong Shin1, Myoung-A Kim1, Seong Yong Lee1, Seong Hee Jang1, Eun Sil Dong1, Chong Jae Kim2, Young Min Ahn1, Je Geun Chi2
1Department of Pediatrics, Kangnam General Hospital Public Co., Seoul, Korea
2Department of Pathology, College of Medicine, Seoul National University, Seoul, Korea
영아 돌연사에 대한 고찰(13 부검례를 포함한 34례 분석)
문여옥1, 최희경1, 허정아1, 신우종1, 김명아1, 이성용1, 장성희1, 동은실1, 김종재2, 안영민1, 지제근2
1지방공사 강남병원 소아과
2서울대학교 의과대학 병리학교실
Correspondence: 
Young Min Ahn, Email: ymahn@kangnamhosp.or.kr
Abstract
Purpose
: The purpose of this study is to analyze the epidemiologic characteristics of sudden unexpected death in infancy and to evaluate the importance of postmortem autopsy.
Methods
: We reviewed, retrospectively, medical records of 34 infants admitted to Kangnam General Hospital from January 1987 to December 2001 because of sudden unexpected death. We investigated the cause of death through medical history, death scene examination, autopsy findings, acylcarnitine and organic acid analysis.
Results
: Among the total 34 infants, 18 were male(52.9%) and 16 were female(47.1%). Thirty infants(88%) were below the six months of age. Winter was the most affected season(38.2%). Eighteen infants(52.9%) died between 6 and 12AM. The prone sleeping position was observed more frequently than the supine position at death; nine cases in the prone position, six cases in the supine position. The cause of death of 23 cases could not be found by only history and death scene examination. Autopsy was done in 13 cases. Seven cases of them were thought to be SIDS. In six cases, we explained the cause of death with autosy findings. They were an endocardial fibroelastosis, a nesidioblastosis, a subdural hematoma, a bronchopneumonia and two fatty changes of liver. Metabolic screening tests performed in three cases to rule out metabolic disorder since 2000 were all normal.
Conclusion
: We concluded that autopsy and metabolic screening test should be performed to find out the cause of death in sudden unexpected death in infancy.
Key Words: Sudden unexpected death in infancy, Sudden infant death syndrome(SIDS), Autopsy, fatty acid oxidation disorder(FAOD)


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