Sudden Infant Death in Stockholm

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Abstract
During a ten year period, March 1976-February 1986, 83 non-selected consecutive cases of sudden unexpected death in infants, between one week and one year of age, were examined at the Department of Forensic Medicine in Stockholm. Forty-three deaths (52%) were classified as typical or possible cases of Sudden Infant Death Syndrome (SIDS), 35 (42%) as non-violent non-SIDS cases and 5 (6%) as non-natural deaths. Cardiovascular disease, including myocarditis, was found in 21 (25%) instances, infections with inflammatory manifestations in various organs outside the heart in 12 (14%) and miscellaneous, non-violent causes of death in 2 (2%) cases. The male:female ratio was 1.15:1 for SIDS and 1.30:1 for non-SIDS cases. A peak of incidence was found for SIDS cases in infants between two and four months of age, while non-SIDS victims tended to be somewhat older. Ninety-five percent of the SIDS fatalities occurred during the winter months (October-April) as compared to 71% of the non-SIDS cases. Outdoor temperature below the annual mean of 5.9.degree.C in combination with a sudden decrease in temperature was associated with sudden deaths, particularly SIDS. Thirty-three percent of the SIDS victims died in their cribs compared to 51% of the non-SIDS cases. Corresponding figures for deaths outdoors in a pram were 33% and 11%, respectively. Fourteen percent of the infants in both groups died while in bed with one of the parents. Ninety-five percent of the SIDS victims were previously healthy, but in 9% one or more periods of abnormal breathing had been noted. The corresponding figures for non-SIDS were 70% and 3%, respectively. Among the cases of non-natural deaths was one infant who died of heroin poisoning and one of hypothermia.

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