Volume 24, Issue 4 (October 1979)
Toxicological Analyses in Cases of Sudden Infant Death: A National Feasibility Study
Sudden infant death syndrome (SIDS) is associated with more infant deaths, ages two weeks to twelve months, in the United States than any other single, definable cause. It is associated with approximately 10 000 deaths per year and is second only to the general category of accidental deaths for all children under the age of 15 years . Unlike many disease entities, the diagnosis of SIDS is made not by an attending physician, but at postmortem examination; the determination is based not on firm definitive findings, but only on the exclusion of all other possible causes. Indeed, very few histological, biochemical, or physiological changes that might be considered pathologically diagnostic in these infants have been observed [1,2]. Although SIDS-associated deaths represent a major proportion of all infant fatalities, their frequency is such that even in jurisdictions of greater than one million population medical examiners and coroners encounter relatively few of these cases, typically 40 to 60 cases a year . In an attempt to overcome the limitation of the small number of SIDS cases available for study in any one area, the Office for Maternal and Child Health, Department of Health, Education, and Welfare, is studying the feasibility of a national SIDS registry . Such a registry could draw on the case experiences of many investigators so that statistically valid correlations and conclusions would be possible; both biomedical and sociological information, drawn from a variety of sources, could be gathered and analyzed. To establish such a data center, it would also be necessary to have strong guidelines specifically designed to control the quality of the data and the methods used in their collection. The formulation of a standard protocol for the investigation of sudden infant deaths that could be used at all sites contributing information would be a first essential task.