Gliosis in neonatal SUDI cases

Abstract

To review sudden unexpected infant deaths (SUDI) in the first 28 days of life referred to a Coronial Perinatal Forensic Pathology Service over a 10-year period from 2000 to 2009. Cases were collected from mortuary records, and a retrospective review of autopsy reports and other available infant records was undertaken. Twenty-four neonatal SUDI were reviewed. For eight infants, a diagnosis was made at autopsy. For the remaining 16 infants, 14 (87.5%) were bedsharing at the time of death. Maori infants and those living in deprived neighbourhoods were over-represented. Only two infants were preterm, and four were growth-restricted. At post-mortem, white matter gliosis was found in 10 of the 16 (62.5%) unexplained SUDI cases. Sudden unexpected infant deaths occur in the first month of life in association with bedsharing. Gliosis may be an important associated risk factor, and its presence indicates a previous insult of prenatal onset.