The use of post-mortem lividity to determine sleep position in sudden unexpected deaths in infancy. 2020

Rebecca Shipstone, and John M D Thompson, and Jeanine Young, and Roger W Byard
School of Nursing, Midwifery, and Paramedicine, University of the Sunshine Coast, Sippy Downs, Queensland, Australia.

To compare parental reports of position found in sudden unexpected deaths in infancy (SUDI) to autopsy reports of lividity and to more accurately classify infant sleep position. Cases of SUDI in Queensland between 2010 and 2014 were reviewed to determine the position in which infants were reported to have been placed and found. This was compared to the distribution of post-mortem lividity at autopsy. Evidence of lividity present during early death scene investigation was also recorded. There was a discordance between the position an infant was reported to have been found and the position of lividity at autopsy in 22/228 SUDI (9.6%). All infants had anterior lividity despite 13 reportedly found supine, three on their side and six in an unknown position. Using anterior lividity at autopsy to change the position found increased the proportion of prone infants from 37.7% to 47.4%. In 47.8% cases, anterior or lateral lividity reported at the scene was no longer present at autopsy. Previously published odds ratios may have underestimated the risk of sudden infant death associated with prone sleep position. SUDI death scene investigation protocols should require photographic documentation of lividity prior to transporting an infant.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001344 Autopsy Postmortem examination of the body. Autopsies,Post-Mortem Examination,Postmortem Examination,Examination, Post-Mortem,Examination, Postmortem,Examinations, Post-Mortem,Examinations, Postmortem,Post Mortem Examination,Post-Mortem Examinations,Postmortem Examinations
D012307 Risk Factors An aspect of personal behavior or lifestyle, environmental exposure, inborn or inherited characteristic, which, based on epidemiological evidence, is known to be associated with a health-related condition considered important to prevent. Health Correlates,Risk Factor Scores,Risk Scores,Social Risk Factors,Population at Risk,Populations at Risk,Correlates, Health,Factor, Risk,Factor, Social Risk,Factors, Social Risk,Risk Factor,Risk Factor Score,Risk Factor, Social,Risk Factors, Social,Risk Score,Score, Risk,Score, Risk Factor,Social Risk Factor
D012890 Sleep A readily reversible suspension of sensorimotor interaction with the environment, usually associated with recumbency and immobility. Sleep Habits,Sleeping Habit,Sleeping Habits,Habit, Sleep,Habit, Sleeping,Habits, Sleep,Habits, Sleeping,Sleep Habit
D013398 Sudden Infant Death The abrupt and unexplained death of an apparently healthy infant under one year of age, remaining unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene, and review of the clinical history. (Pediatr Pathol 1991 Sep-Oct;11(5):677-84) Cot Death,Crib Death,SIDS,Death, Sudden Infant,SID,Sudden Infant Death Syndrome,Cot Deaths,Death, Cot,Death, Crib,Infant Death, Sudden
D016017 Odds Ratio The ratio of two odds. The exposure-odds ratio for case control data is the ratio of the odds in favor of exposure among cases to the odds in favor of exposure among noncases. The disease-odds ratio for a cohort or cross section is the ratio of the odds in favor of disease among the exposed to the odds in favor of disease among the unexposed. The prevalence-odds ratio refers to an odds ratio derived cross-sectionally from studies of prevalent cases. Cross-Product Ratio,Risk Ratio,Relative Odds,Cross Product Ratio,Cross-Product Ratios,Odds Ratios,Odds, Relative,Ratio, Cross-Product,Ratio, Risk,Ratios, Cross-Product,Ratios, Risk,Risk Ratios
D016684 Prone Position The posture of an individual lying face down. Position, Prone,Positions, Prone,Prone Positions

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