Ten Percent of SIDS Cases are Murder — or are They?

Milroy, Christopher M.; Kepron, Charis

doi:10.23907/2017.018

Cited by 10 publications

(5 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The limited frequency of autopsies may lead to a misdiagnosis of sudden infant death syndrome (SIDS), or sudden unexpected death in infancy (SUDI) [ 21 , 22 ]. A small fraction of reported SIDS/SUDI cases may be covert NAI; of note, the distribution of SIDS has remained stable over the years while preventive measurements have been drastically improved [ 23 , 24 ]. For example, Cote et al [ 25 ] reported that 2.6% of 623 deaths attributed to SIDS were actually due to NAI.…”

Section: Discussionmentioning

confidence: 99%

High prevalence of non-accidental trauma among deceased children presenting at Level I trauma centers in the Netherlands

Loos

Bakx

Duijst

et al. 2021

Forensic Sci Med Pathol

View full text Add to dashboard Cite

Purpose Between 0.1—3% of injured children who present at a hospital emergency department ultimately die as a result of their injuries. These events are typically reported as unnatural causes of death and may result from either accidental or non-accidental trauma (NAT). Examples of the latter include trauma that is inflicted directly or resulting from neglect. Although consultation with a forensic physician is mandatory for all deceased children, the prevalence of fatal inflicted trauma or neglect among children is currently unclear. Methods This is a retrospective study that included children (0–18 years) who presented and died at one of the 11 Level I trauma centers in the Netherlands between January 1, 2014, and January 1, 2019. Outcomes were classified based on the conclusions of the Child Abuse and Neglect team or those of forensic pathologists and/or the court in cases referred for legally mandated autopsies. Cases in which conclusions were unavailable and there was no clear accidental cause of death were reviewed by an expert panel. Results The study included 175 cases of childhood death. Seventeen (9.7%) of these children died due to inflicted trauma (9.7%), 18 (10.3%) due to neglect, and 140 (80%) due to accidents. Preschool children (< 5 years old) were significantly more likely to present with injuries due to inflicted trauma and neglect compared to older children (44% versus 6%, p < 0.001, odds ratio [OR] 5.80, 95% confidence interval [CI] 2.66–12.65). Drowning accounted for 14 of the 18 (78%) pediatric deaths due to neglect, representing 8% of the total cases. Postmortem radiological studies and autopsies were performed on 37 (21%) of all cases of childhood death. Conclusion One of every five pediatric deaths in our nationwide Level I trauma center study was attributed to NAT; 44% of these deaths were the result of trauma experienced by preschool-aged children. A remarkable number of fatal drownings were due to neglect. Postmortem radiological studies and autopsies were performed in only one-fifth of all deceased children. The limited use of postmortem investigations may have resulted in missed cases of NAT, which will result in an overall underestimation of fatal NAT experienced by children.

show abstract

Section: Discussionmentioning

confidence: 99%

High prevalence of non-accidental trauma among deceased children presenting at Level I trauma centers in the Netherlands

Loos

Bakx

Duijst

et al. 2021

Forensic Sci Med Pathol

View full text Add to dashboard Cite

show abstract

“…[9][10][11] These percentages have been criticized due to the low scientific and medical evidence and have been deemed unreliable, 12,13 and estimates were thought to be less than 10%. [3][4][5] Following the subsequent dramatic decline in "SIDS" associated with the "Back to Sleep" campaign in the United States, Pollack 5 reported that covert homicide in 'cot death' represents only a small fraction of reported "SIDS" deaths. Pollack's study may represent the most scientific and statistically robust study on covert homicide in cot death after the "Back to Sleep" campaign.…”

Section: Discussionmentioning

confidence: 99%

“…Other studies have reported a percentage of 1.3% to up to 40% in England and United States 9–11 . These percentages have been criticized due to the low scientific and medical evidence and have been deemed unreliable, 12,13 and estimates were thought to be less than 10% 3–5 . Following the subsequent dramatic decline in “SIDS” associated with the “Back to Sleep” campaign in the United States, Pollack 5 reported that covert homicide in ‘cot death’ represents only a small fraction of reported “SIDS” deaths.…”

Section: Discussionmentioning

confidence: 99%

“…However, missing a homicide is a potential risk if a postmortem examination is not performed in an infant presenting as a cot death. A number of studies have examined covert homicide in "cot deaths"/"SIDS" and reported that a variable percentage of these cases are due to homicide, but the likelihood is thought to be low, [3][4][5] creating further disincentive to performing a postmortem examination in infants presenting as cot deaths. However, these studies selected cases that were considered "cot death"/"SIDS," or undetermined cause after the postmortem examination, rather than selecting cases "presenting" as cot deaths before postmortem examination.…”

mentioning

confidence: 99%

See 1 more Smart Citation

A 5-Year Retrospective Study on Infant Homicide Presenting as Cot Death

Tse

Ioelu²,

Chen³

et al. 2021

Am J Forensic Med Pathol

View full text Add to dashboard Cite

Being found dead in cot or bed is the most common presentation encountered with infant deaths. These deaths are often associated with unsafe sleep environment. The postmortem examination in such cases is often negative, and along with family objections, cultural, and other factors, may lead to a coroner considering not authorizing a postmortem examination. However, not identifying a homicide is a potential risk if a postmortem examination is not performed. This 5-year retrospective study investigated the proportion of infant homicide death initially presenting as cot death. Of a total of 103 cases of infants initially presenting as being found dead in cot or bed, 3 (approximately 3%) were classified as homicides after postmortem examination. During the study period, a total of 9 infant homicides were reported, translating to 33% (3 of 9) of infant homicides presented as cot deaths. Postmortem radiology was a valuable adjunct, but was unable to recognize 2 of the homicide cases with traumatic head injuries (with subdural hemorrhage and brain injury only). We strongly advocate that all infant deaths presenting as cot death require a full postmortem examination.

show abstract

“…Parents have been observed trying to suffocate and harm their infants, 7,[40][41][42] and estimates of the incidence of infanticide among cases designated as sudden infant death have ranged from 1% to 10%. 43 Certain circumstances in the medical history can indicate increased risk for intentional suffocation, 44 including:…”

Section: Child Maltreatment Fatalitymentioning

confidence: 99%

Identifying Child Abuse Fatalities During Infancy

et al. 2019

View full text Add to dashboard Cite

When a healthy infant dies suddenly and unexpectedly, it is critical to correctly determine if the death was caused by child abuse or neglect. Sudden unexpected infant deaths should be comprehensively investigated, ancillary tests and forensic procedures should be used to more-accurately identify the cause of death, and parents deserve to be approached in a nonaccusatory manner during the investigation. Missing a child abuse death can place other children at risk, and inappropriately approaching a sleep-related death as maltreatment can result in inappropriate criminal and protective services investigations. Communities can learn from these deaths by using multidisciplinary child death reviews. Pediatricians can support families during investigation, advocate for and support state policies that require autopsies and scene investigation, and advocate for establishing comprehensive and fully funded child death investigation and reviews at the local and state levels. Additional funding is also needed for research to advance our ability to prevent these deaths.

show abstract

Ten Percent of SIDS Cases are Murder — or are They?

Cited by 10 publications

References 25 publications

High prevalence of non-accidental trauma among deceased children presenting at Level I trauma centers in the Netherlands

High prevalence of non-accidental trauma among deceased children presenting at Level I trauma centers in the Netherlands

A 5-Year Retrospective Study on Infant Homicide Presenting as Cot Death

Identifying Child Abuse Fatalities During Infancy

Contact Info

Product

Resources

About