REVIEW   

Minerva Pediatrics 2021 October;73(5):435-43

DOI: 10.23736/S2724-5276.20.05599-1

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Multidisciplinary study of sudden unexpected infant death in Liguria (Italy): a nine-year report

Francesco VENTURA ¹ ✉, Rosario BARRANCO ¹, Anna SMITH ¹, Isabella CECCHERINI ², Roberto BANDETTINI ³, Domenico COVIELLO ⁴, Anna MORANDO ⁵, Paolo NOZZA ⁶, Francesca BUFFELLI ⁷, Ezio FULCHERI ^{7, 8}, Antonella PALMIERI ⁹

¹ Department of Forensic and Legal Medicine, University of Genoa, Genoa, Italy; ² Unit of Medical Genetics, Giannina Gaslini Institute, Genoa, Italy; ³ Unit of Bacteriology, Giannina Gaslini Institute, Genoa, Italy; ⁴ Laboratory of Human Genetics, Giannina Gaslini Institute, Genoa, Italy; ⁵ Section of Analytic Toxicology, La Colletta Hospital, ASL 3 Genovese, Arenzano, Genoa, Italy; ⁶ Section of Clinical Pathology, Galliera Hospital, Genoa, Italy; ⁷ Unit of Fetal and Perinatal Pathology, Giannina Gaslini Institute, Genoa, Italy; ⁸ School of Medicine, University of Genoa, Genoa, Italy; ⁹ Department of Pediatric Emergency, Sudden Infant Death Syndrome Liguria Center, Giannina Gaslini Institute, Genoa, Italy

INTRODUCTION: We conducted a retrospective analysis of cases of sudden unexpected infant death (SUID) referred to the SIDS-ALTE Center of the Liguria Region (Italy) from 2010 to 2018. In all cases, the death scene was inspected, and a multidisciplinary post-mortem evaluation was conducted. Our aim was to analyze the epidemiological data and etiological distribution.
EVIDENCE ACQUISITION: We examined 15 cases initially classified as sudden infant death.
EVIDENCE SYNTHESIS: In all cases, the death was initially unexplained. Seven cases involved males and eight involved females. Their mean age was 67.47 days; the youngest victim was 2 days old, while the oldest was 8.5 months (253 days). In 7 cases, the post-mortem analysis showed an infection of lung. In 4 cases, the prone position of the infant during sleep was identified as a risk factor. Only in one case the cause of death remains unexplained, and it was classified as sudden infant death syndrome II according to San Diego Classification.
CONCLUSIONS: In the forensic approach to cases of SUID, it is always important to conduct a thorough multidisciplinary investigation. In order to avoid procedural errors that might compromise the post-mortem investigation, it is necessary to consider the medical and social history of both mother and child, in addition to the circumstances of the death. Moreover, a complete pediatric post-mortem examination and multidisciplinary discussion are required in order to identify potentially important causative or contributory factors.

KEY WORDS: Infant death; Autopsy; Sudden infant death