The pathology of the sudden infant death syndrome

Abstract

As has been already remarked in Chapter 9, Beckwith defined SIDS, now the most common cause of death in the immediate postneonatal period, as follows: ‘The sudden death of any infant or young child which is unexpected by history and in which a thorough post-mortem examination fails to reveal a cause’ [1]. This definition has gained wide, if not universal, acceptance since its introduction in 1969. It implies that the morphological features of the disease must be subtle and not readily identified by the usual techniques; taken literally, it might inhibit any discussion of the pathology of the syndrome. However, if we add ‘other than those manifestations usually observed in such disease’, we may proceed without offending logic [2]. Alternatively, we can use Adelson’s definition — which preceded that of Beckwith — ‘the death of a child who was thought to have been in good health or whose terminal illness appeared to be so mild that the possibility of a fatal outcome was not anticipated’ [3]; the implications of a negative necropsy are thereby avoided.