Sudden Infant Death Syndrome Research Today is a free monthly online journal that collates and summarizes the latest research about Sudden Infant Death Syndrome, including details on sids, causes, prevention, statistics.

Intrathoracic Petechial Hemorrhages in sudden infant death syndrome and other infant deaths: Time for re-examination?

Goldwater PN

Abstract Objective: To provide a predictive tool to assist forensic and pediatric pathologists in diagnosis of sudden unexpected infant death and to discuss the pathogenesis of intrathoracic petechial hemorrhages. Design: retrospective autopsy report review of 174 SIDS cases (2004 definition) and 67 age-matched comparison deaths. Setting: Qualitative assessment (presence or absence) of macroscopic intrathoracic petechiae in SIDS and age-matched comparison sudden unexpected deaths that occurred in the late 1980s and early 1990s. Main outcome measures: Sensitivity, specificity and positive and negative predictive values for thymic, pleural and epicardial petechial hemorrhages were developed. Results: 89.5%, 80% and 79.9% SIDS (<12 months of age) had thymic, pleural and epicardial petechiae respectively compared with 47.6%, 47.5% and 43.6% in non-SIDS deaths respectively. Respective ORs: 9.4 (4.5-19.9), 4.6 (2.3-9.1), 5.3 (2.6-10.8). When all three intrathoracic organ sites contain macroscopic petechiae, this is 84.9% predictive of SIDS and when all 3 sites have no detectable petechiae this is 93.1% predictive of a non-SIDS diagnosis. Conclusions: Careful assessment of intrathoracic petechiae at autopsy is likely to be diagnostically useful in assessment of sudden unexplained infant death.

Published 17 April 2008 in Pediatr Dev Pathol.
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