Dead Infants Research Articles

Four-Year Bacteriological Profile and Antibiotic Resistance Rate of Neonatal Blood Cultures in a Major Neonatal Intensive Care Unit (NICU) in Shiraz, Southwest Iran

Background: Bacterial infections are the leading cause of death in newborns. The growing resistance of bacteria to antibiotics is a major concern. In this study, we identified isolates from blood cultures in the neonatal intensive care unit (NICU) of a major referral hospital in Shiraz in southwest Iran and determined antibiotic resistance patterns. Methods: All newborns admitted to the NICU were evaluated in a four-year study. The blood samples were cultured using a BACTEC system. From May 2015 to March 2020, 5937 blood culture samples were analyzed. The antibacterial sensitivity test was conducted using the disk diffusion method, following the guidelines of Clinical & Laboratory Standards Institute (CLSI) 2018. Results: In this study, 507 isolates were obtained from 5937 specimens. The most commonly isolated gram-negative bacteria were Acinetobacter (8.7%), Escherichia coli (5.7%), Klebsiella (1.6%), Enterobacter (1.4%), and Pseudomonas (0.9%). Among the gram-positive bacteria, coagulase-positive staphylococci (51.1%), coagulase-negative staphylococci (15.4%), Staphylococcus epidermidis (10.2%), non-hemolytic streptococci (2.4%), alpha-hemolytic streptococci (1.4%), and Streptococcus pneumonia (1.3%) were the most frequently isolated bacteria. Of the 318 Staphylococcus aureus isolates, 88.5% were resistant to methicillin. Conclusion: Staphylococcus, with a high frequency in the NICU, can be an alarm for medical centers. Also, in dead infants, the most observed bacterial infection was Acinetobacter infection, which requires the serious attention of the hospital infection control unit.

DNA Profiling of Dry Umbilical Cord Tissue Unfolds the Mystery of Disowned Dead Female Infant

DNA Profiling of Dry Umbilical Cord Tissue Unfolds the Mystery of Disowned Dead Female Infant

Record of thanatology and cannibalism in drills (Mandrillus leucophaeus)

Comparative thanatology includes the scientific study of death in non-human animals, which involves emotional, social, and exploratory responses of individuals and groups towards corpses. Stillborn babies and dead infants often elicit maternal and alloparental care that can persist for days, weeks, or even months, especially in primates. After this period, cannibalistic acts can occur not only by groupmates but also by the mother. Such cannibalism has been reported both in captive and wild primate groups, suggesting that the phenomenon is evolutionary adaptive. Here, we report a case in drills (Mandrillus leucophaeus), a largely unstudied monkey species. We collected data from the birth to the death of the infant on maternal and alloparental care towards the newborn across three phases: pre-mortem, post-mortem, and post-mortem cannibalism. The mother maintained high levels of grooming after the infant’s death. Both the mother and other group members interacted with the dead baby by trying to engage its gaze. Two days after the death, the mother started to eat the corpse until it was almost completely consumed; there was no sharing with other group members. Although we cannot draw firm conclusions about potential benefits of the mother’s behavior, this observation on drills adds a piece to the puzzle of thanatological behaviors and cannibalism in primates.

MORPHOLOGICAL EVOLUTION AND DIAGNOSIS OF BRONCHOPULMONARY DYSPLASIA IN VERY PRETERM INFANTS

Bronchopulmonary dysplasia (BPD) remains one of the most common and severe diseases in very preterm infants, which can cause death. Since the first description of BPD in 1967, not only understanding of the disease’s nature, its definition, classification, epidemiology, features of the clinical course, diagnosis, prevention, treatment, and prognosis but the specific autopsy histopathological features have changed. The primarily reason for these is considered a change in the population of sick and dead infants as a result of improving clinical practice, increasing the survival rates of the most immature neonates, and reducing the incidence of severe BPD forms and the associated mortality.The BPD form that has been described initially is now called "old" BPD and is characterized by significant lung injury. In the smallest neonates, who were treated with exogenous surfactant, the histopathological signs of the disease changed, determining the need to modify the theoretical concept of BPD. The leading feature of the new BPD form was the disorder of lung development and formation, not their injury. Morphologically, this was manifested by a reduced number and simplified structure of acini, changes in the capillary structure with less obvious fibrosis of the lungs. Such morphometric methods as the radial alveolar count and the count of mean number of alveoli intercepts can be used for the histopathological diagnosis of a simplified lung structure. The use of these techniques helps to objectively assess lung growth retardation. Although the number of cases of "new" BPD currently prevails, some autopsies are still characterized by histopathological changes typical for the "old" form of the disease. A combination of classic and new features is also possible. When establishing a pathological diagnosis of BPD, it is essential to consider all specific histopathological changes that may indicate the presence and severity of the disease, as well as its role in thanatogenesis. This is important not only for the correct postmortem diagnosis of BPD, but also for the studying of various disease phenotypes.The article describes the main histopathological characteristic of various BPD forms, as well as methods of evaluating the simplified lung structure.

Postmortem treatment of preterm infants at the Gangshang site during the Late Neolithic period, Shandong Province, China

AbstractJar burial is a particular burial practice generally used in the Neolithic period of China. However, the rarity of finding prenatal individuals limits the ability to study their treatment in jar burial contexts. In this paper, to study the postmortem treatment of this specific age further, we focus on three jar burials of infant individuals excavated in 2021 at the Gangshang site in China, where the skeletal remains were relatively well preserved. The skeletal remains of three well‐preserved individuals are presented into inverted ceramic tripods near the residential area and with a crouched posture. In terms of this condition, we apply the osteometric method to estimate the range and mean of age at death for each individual investigated. Meanwhile, we use micro‐computed tomography (CT) scans to help judge the degree of microbial bioerosion. Besides, histological analysis on skeletal remains combined with the Oxford Histological Index (OHI) assessment allows us to estimate the developmental stage at the time of death by analyzing the results of micro‐CT scans. By using osteometric methods, the results show that the gestational age of the three individuals is 22–26, 24–28, and 22–26 weeks, respectively. The results of the micro‐CT scans indicate that all three fetuses died shortly after birth, or had died in their mother's uterus before birth, with the OHI score of 5. Moreover, we indeed observe infant skeleton remains with no bacterial bioerosion, indicating that it is effective using this method to judge the developmental stage at the time of death with a specific taphonomic environment in the Gangshang site of the Dawenkou culture period. Combined with the placement of the jars in which the three infants were buried, it is believed that this unique placement method was intentional and specific to the infant deaths. These results are instructive for exploring the postmortem treatment of dead infants by ancient residents of the Dawenkou culture period (4200 bc–2600 bc) in Shandong Province, China, and the significance and possible causes of the unique burial type.

Dead Infants and Taking the Fifth

Dead Infants and Taking the Fifth

The Kerry Babies, criminology, and Reinhart Koselleck

The Kerry Babies case was a criminal investigation that followed the discovery of a dead infant on a beach in the southwest of Ireland in April 1984. Charges were laid and dismissed. A tribunal of inquiry into alleged police malpractice followed, and the case returned to the courts 35 years later. This paper takes a multidimensional approach to historical time, drawing on the works of German philosopher Reinhart Koselleck to analyse the case, its legacy, and its implications for criminological theory. A Koselleckian approach – drawing in particular on the role of anachronisms, the mobilisation of memory and the categories of experience and expectation – facilitates a novel perspective on child killing, unmarried motherhood, and policing in 20th-century Ireland.

CLINICAL AND MORPHOLOGICAL CORRELATES OF PINEAL GLAND FUNCTION IN INFANTS WITH EXTREMELY LOW BODY WEIGHT

Introduction. The functional activity of the pineal gland plays a dramatic important role in the adaptation topostnatal life and in the pathogenesis of the most common perinatal pathology of premature infants.The aim of the study. To determine the morphofunctional features of the pineal gland in premature infants withextremely low body weight.Material and methods. In 46 preterm infants with extremely low birth weight, the level of melatonin metabolite inurine 6-sulfoxymelatonin was determined at first day of life. The 20 dead infants underwent macro- and microscopicexamination of the pineal gland using the immunohistochemical method.Results. All preterm infants with extremely low birth weight had perinatal pathology, which led to death in 20 ofthem. Urinary excretion of the metabolite melatonin 6-sulfoximelatonin in preterm infants with extremely low birthweight in the first day of life, which had fatal consequences, significantly reduced compared with surviving children,indicating depletion of functional activity of the pineal gland and may be as a marker of adverse course of the neonatalperiod. Morphologically, in the pineal gland of premature infants with extremely low body weight there is an increasein morphofunctional activity of pineal cells. This is confirmed by morphometric data and increased expression ofMelanA and S100 in immunohistochemical studies. Macro- and microscopic data suggest that extrauterine existencein distress conditions accelerates the differentiation of the pineal gland (depletion) and indicates the presenceof damage to glandular tissue, which in turn reduces the synthesis of melatonin and its mediated metabolite 6 –sulfoxymelatonin in urine.Conclusions. Decreased urinary excretion of 6-sulfoximelatonin in preterm infants with extremely low birthweight in the first day of life and mophological changes in the pineal gland of deceased children indicate depletionof functional activity of the pineal gland in conditions of perinatal pathology

The frequency of pregnancy recognition across the gestational spectrum and its consequences in the United States

The frequency of pregnancy recognition across the gestational spectrum and its consequences in the United States

Ghost Children: Delayed Personhood and Culture-specific Models of Infancy in Western Anatolia

Abstract Most societies view infants and partially children, up to a certain age, as not fully human beings and/or persons. This paper takes a longue durée perspective to examine built spaces shared by the living and dead infants during the four millennia (seventh to third millennium BC) in Anatolia. Evidence of infant burials within and around houses in several prehistoric periods and sites is analysed through a child-centred approach to mortuary remains, which does not equate adults with subadults or fully human with not fully human beings. This allows us to gain new perspectives of how age, age groups and infancy or childhood were perceived in prehistory. By perceiving houses as social spaces where ritual and non-ritual mimesis is embodied in shared practices and beliefs, where the material and social collide, rather than simply as signifiers of social units, we are better able to grasp subadult identities and decipher the personhood of infants and children through mortuary practices. Through our Anatolian case study, we provide socio-anthropological explanations for keeping the ‘ghost children’, buried close to houses, due to delayed personhood. We argue for constructing culture-specific models of infancy based on the archaeological evidence in Anatolia and beyond.

Maternal caretaking behavior towards a dead juvenile in a wild, multi-level primate society

Maternal caretaking and transport of dead infants are widespread among nonhuman primates, having been reported in numerous species of monkeys and apes. By contrast, accounts of such behaviors toward dead juveniles are scarce. Here, we describe responses by the mother and other group members to the death of a juvenile in a wild, multi-level group of Sichuan snub-nosed monkeys (Rhinopithecus roxellana). Following the juvenile’s fatal accident, his mother transported and cared for the corpse for four days. Immature monkeys belonging to the same one-male unit, and some individuals from other social units also showed interest in and tended the corpse. Comparisons of this case with those involving the deaths of infants and an adult female in the same population highlight possible effects of physiological, psychological and emotional factors in primate thanatological responses, and provide an additional perspective on the origin and evolution of compassionate acts.

『매장된 아이』에 나타난 폭력성과 욕망의 결핍 고찰

The purpose of this study is to examine the expression of violence caused by concealed infant murder, family indifference, and lack of desire among families in Sam Shepard''s Buried Child. In the family, violence is used not only as a means of pommunication, but also as a means of restoring lost masculine authority, acknowledging one''s existence, and satisfying a lack of desire. The violence presented in Buried Child does not occur in special situations, but is a representation of everyday life. Families treat each other with indifference and criticism while sharing secrets with each other. The head of the family loses control and is merely an object of violence. Lethargy, loss of vitality, and criticism of others are key factors that shape the atmosphere in the home. In the final scene of Buried Child, the body of a dead infant is revealed, suggesting the possibility of resolving the cause of the conflict between the families. The buried child is not only a dead infant, but also a spiritually symbolized expression of the neglected indifference in the family consciousness. Therefore, the revealing of the buried child symbolically suggests that the realization of the recognition that indifference caused the severance of the family was achieved among the families. In conclusion, this epistemological realization can be seen as showing the possibility of new hope while suggesting the future direction of the family. (Anyang University)

Putrescine--a chemical cue of death—is aversive to chimpanzees

As in many other species of nonhuman primates, chimpanzee mothers with a dead infant may continue to care for and transport the infant for days, weeks, or even longer. The bereaved females do this despite what humans perceive as the foul odour from the putrefying corpse. Putrescine is a major contributor to the “smell of death,” and it elicits behaviours aimed at getting rid of the source of the smell, or escape responses in mammals including humans. However, it has never been shown that the odour of putrescine is aversive to chimpanzees. To address this question, we visually presented six adult chimpanzees with the corpse of a small bird, or a stuffed glove, in association with putrescine, ammonia, or water, and recorded the chimpanzees’ reactions. The apes spent significantly less time near the object when it was paired with putrescine than the other substances, although they showed no signs of increased arousal or anxiety. We interpret the findings as evidence of an aversion to the smell of death in chimpanzees, discuss the implications for understanding the continued maternal-like behaviour of bereaved female chimpanzees, and suggest future research directions for the field of comparative evolutionary thanatology.

Verbal Autopsies for Out-of-Hospital Infant Deaths in Zambia.

In Zambia, a significant number of infants die in the community. It is hypothesized that delays in care contribute to many of these so-called "brought in dead" infants. We analyzed free-text narratives from verbal autopsies, in which families narrate the final series of events leading to each infant's death. Using the 3-delays model framework and working iteratively to achieve consensus, we coded each narrative using NVivo software to identify, characterize, and quantify the contribution of delays and other factors to the fatal outcome. Verbal autopsies were collected from 230 families of brought in dead infants younger than 6 months of age. As many as 82.8% of infants had 1 or more delays in care. The most-common delay was in the family's decision to seek care (54.8%), even as severe symptoms were frequently described. Similarly, 27.8% of infants died en route to a health care facility. Delays in receiving adequate care, including infants dying while waiting in line at a clinic or during referral from a clinic to a hospital, occurred in 24.7% of infants. A third of infants had been previously evaluated by a clinician in the days before their death. Delays in care were the rule rather than the exception in this population of Zambian infants. Accessing care requires families to navigate significant logistic barriers, and balance complex forces in deciding to seek care. Strategies to avoid such delays could save many infants lives.

Postmortem MRI Characterization of Cadaveric Hypostases in Deceased Newborns.

Using postmortem MRI, we studied the features of the development of internal cadaveric hypostasis in dead newborns. Postmortem radiological and pathoanatomical examination of 62 bodies of newborns and infants who died at the age of 1.5 h to 49 days was carried out. After the death was ascertained, prior to MRI, the bodies were stored in a refrigerator at 4°C in the supine position. Depending on the duration of the postmortem period (2-72 h), all observations were divided into eight groups. Prior to autopsy, an MRI scan was performed in T1 and T2 standard modes, followed by analysis of the presence and severity of the gradient line of the intensity of the MR signal in the liver and lung tissue in the ventral (overlying) and dorsal (underlying) areas, as well as the presence of a gradient of the intensity of the blood signal in the heart cavity and in the aortic lumen. The main manifestations of cadaveric hypostasis in the liver and lungs are changes of the MR signal intensity in the ventral and dorsal regions with the appearance of a horizontal gradient of the MR signal intensity, which reflects the location of the body after death. In the heart cavity and in the aortic lumen, there is also a gradient of the blood signal intensity of various severity with the visualization of two or three of its layers. The revealed features of the MRI signal intensity and, accordingly, the presence of its horizontal gradient depended not only on the MRI mode of the study, but also on the studied organ and the duration of the postmortem period. This should be taken into account when analyzing the results of virtopsy and determining the links of thanatogenesis of dead newborns and infants.

Infant cannibalism in wild white-faced capuchin monkeys.

Cannibalism has been observed in a variety of animal taxa; however, it is relatively uncommon in primates. Thus, we rely heavily on case reports of this behavior to advance our understanding of the contexts under which it occurs. Here, we report the first observation of cannibalism in a group of wild white‐faced capuchin monkeys (Cebus imitator). The subject was a dead infant, estimated to be 10 days old, and the probable victim of infanticide. Consumption of the corpse was initiated by a 2‐year‐old male (second cousin of the infant), though it was eventually taken over and monopolized by the group's alpha female (grandaunt of the infant). Although most group members expressed interest in the corpse (sniffing, touching, and threatening it), no others made an attempt to consume it. Given that this is the only observation of cannibalism recorded in over 37 years of study on this population, we consider it to be a rare behavior in this species. This detailed record contributes new data, which, when combined with other reports within and across species and contexts, enables the evaluation of adaptive explanations of cannibalism.

The behaviours of a female blonde capuchin (Sapajus flavius) towards her dead infant

Abstract Here we describe the behaviour of a female blonde capuchin (Sapajus flavius) towards her dead infant and discuss possible explanations linked to the anecdotal event. We conducted our study in a fragment of Atlantic forest in Northeastern Brazil where we have been monitoring a blonde capuchin population, with over 163 individuals, since 2010. Our observations show that the behaviours of female blonde capuchins towards dead infant include corpse carrying, which may be related to maternal-bond strength and grief management. Two adult males cooperated with the vulnerable female by protecting her during group travelling even though offspring survival was no longer a possibility. The present study complements the current knowledge of thanatology in Neotropical primates.

Reactions to infant death by wild vervet monkeys (Chlorocebus pygerythrus) in KwaZulu-Natal, South Africa:\xa0prolonged carrying, non-mother carrying, and partial maternal cannibalism

Observations of dead infant carrying have been reported for many primate species, and researchers have proposed several hypotheses to explain this behaviour. However, despite being a relatively well-studied species, reports of dead infant carrying in wild vervet monkeys (Chlorocebus pygerythrus) remain scarce. Here we report 14 observations of dead infant carrying by female vervet monkeys in a population at Mawana Game Reserve, KwaZulu-Natal, South Africa. Most of the females carried the dead infant for a day or less, but one female carried her infant for at least 14 days. In one case the maternal sister of a dead infant carried it after the death of their mother. We also report a case of mother-infant cannibalism: a female consumed part of her deceased infant’s tail. Other post-mortem care-taking behaviours such as grooming, smelling and licking were also recorded. Of 97 recorded infant deaths in this study population since 2010, 14.4% are known to have elicited dead infant carrying, a proportion similar to that reported for other monkey species. We discuss our observations in relation to various hypotheses about this behaviour, including the post-parturition hormones hypothesis, learning to mother hypothesis, and unawareness of death hypothesis.

Why chimpanzees carry dead infants: an empirical assessment of existing hypotheses.

The study of non-human primate thanatology has expanded dramatically in recent years as scientists seek to understand the evolutionary roots of human death concepts and practices. However, observations of how conspecifics respond to dead individuals are rare and highly variable. Mothers of several species of primate have been reported to carry and continue to interact with dead infants. Such interactions have been proposed to be related to maternal condition, attachment, environmental conditions or reflect a lack of awareness that the infant has died. Here, we tested these hypotheses using a dataset of cases of infant corpse carrying by chimpanzees in Gombe National Park, Tanzania (n = 33), the largest dataset of such cases in chimpanzees. We found that mothers carried infant corpses at high rates, despite behavioural evidence that they recognize that death has occurred. Median duration of carriage was 1.83 days (interquartile range = 1.03–3.59). Using an information theoretic approach, we found no support for any of the leading hypotheses for duration of continued carriage. We interpret these data in the context of recent discussions regarding what non-human primates understand about death.

Callitrichid responses to dead and dying infants: the effects of paternal bonding and cause of death.

Many primates show responses to dead infants, yet testing explanations for these behaviors has been difficult. Callitrichids present a unique opportunity to delineate between hypotheses, since unlike most species, male caretakers form closer social bonds with infants than mothers. Callitrichids are also known to commit infanticide, leaving obvious wounds that may enable them to more readily recognize death. We present: (1) a case study of a wild common marmoset (Callithrix jacchus) group responding to an infant's natural death, and (2) a review of published infant deaths across callitrichids (N = 16), testing for trends in the sex of reacting individuals and cause of death. In our case study, several group members frequently interacted with the dead infant, attempting to carry it. However, the strongest response was from a male that remained with the corpse for ~ 3h, despite his group leaving the area. Across callitrichid species, corpse interactions were significantly sex-biased: 100% (N = 6) of accidental deaths involved corpse interaction by males (p = 0.007), compared to 60% (N = 3 of 5) by females (p = 0.095). Cause of death also played a significant role, with individuals attempting to carry dead infants in 100% (N = 6) of accidental deaths, but only 11.1% (N = 1 of 9) of infanticides (p = 0.001). Although the available literature is small and potentially subject to publication biases, these data support the idea that visually obvious wounds may influence callitrichids' perception of dead conspecifics. Additionally, male-biased patterns of corpse interaction in callitrichids indicate that social bonds likely shape reactions to the dead, in addition to kinship. While published data on primate thanatology are limited, this study demonstrates quantitative approaches that can provide empirical insights into primates' responses to dead conspecifics.