Medical, Forensic and Social Quandaries of Sudden Infant Death Syndrome Today


  • Tatiana Iov Institute of Legal Medicine of Iasi, Romania
  • Cristina Furnică “Gr. T. Popa University of Medicine and Pharmacy, Iasi, Romania
  • Sofia Mihaela David Gr. T. Popa University of Medicine and Pharmacy, Iasi, Romania
  • Diana Bulgaru-Iliescu Gr. T. Popa University of Medicine and Pharmacy, Iasi, Romania



Sudden Infant Death Syndrome, risk factors, diagnosis, differential diagnosis, autopsy


Sudden Infant Death Syndrome (SIDS) is described as the sudden, unexplained death (with no attributable cause, during sleep) of a seemingly healthy child before reaching the first year of life. Statistically, SIDS is recognized today as a leading cause of death in infants aged 1 to 12 months. In the present article the authors have analyzed known risk factors, classifications and current standards of forensic investigation while highlighting the necessity of detailed clinical history, autopsy, scene of death examination and lab findings (radiology, metabolic anomalies, infectious diseases and toxicology) in SIDS diagnosis. For an infant death to be considered SIDS, all other possible causes of death must be first excluded, the diagnosis requiring detailed collection and analysis of antemortem patient data and a complete autopsy. Although the forensic methods of today are more exact, the distinction between SIDS and other causes of death (e.g. unintentional asphyxiation, infanticide) remains very difficult in some cases.


American Academy of Pediatrics (2005). The Changing Concept of Sudden Infant Death Syndrome: Diagnostic Coding Shifts, Controversies Regarding the Sleeping Environment, and New Variables to Consider in Reducing Risk; Task Force on Sudden Infant Death Syndrome. Pediatrics, 116(5), 1245-1255.

Arane, K., Claudius, I., & Goldman, R. D. (2017). Brief resolved unexplained event: New diagnosis in infants. Canadian family physician Medecin de famille canadien, 63(1), 39–41.

Bajanowski T, Vege, A., Byard, R.W., Krous, H. F., Arnestad, M., Bachs, L., Banner, J., Blair, P. S., Borthne, A., Dettmeyer, R., Fleming, P., Gaustad, P., Gregersen, M., Grøgaard, J., Holter, E., Isaksen, C. V., Jorgensen, J. V., De Lange, C., Madea, B., Moore, I., Morland, J., Opdal, S. H., Råsten-Almqvist, P., Schlaud, M., Sidebotham, P., Skullerud, K., Stoltenburg-Didinger, G., Stray-Pedersen, A., Sveum, L., & Rognum, T. O. (2007). Sudden infant death syndrome (SIDS) – Standardized investigations and classification: recommendations. Forensic Science International, 165, 129-143.

De Faria Oliveira, A. M., De Andrade, P. R., Pinheiro, E. M., Avelar, A. F., M., Costa, P., & Belela-Anacleto, A. S. C., (2020). Risk and protective factors for sudden infant death syndrome. Revista Brasileira De Enfermagem, 73(2), e20190458.

De Visme, S., Chalumeau, M., Levieux, K., Patural, H., Harrewijn, I., Briand-Huchet, E., Rey, G., Morgand, C., Blondel, B., & Gras-Le, G. C. (2020). National Variations in Recent Trends of Sudden Unexpected Infant Death Rate in Western Europe. Journal of Pediatrics, 226, 179-185.

Farrell, P. A., Weiner, G. M., Lemons, J. A. (2002). SIDS, ALTE, Apnea, and the Use of Home Monitors of Pediatrics. Pediatrics in Review 23(1), 3-9.

Ferrante, L., Opdal, S. H., & Nygaard, V. (2020). No association to sudden infant death syndrome detected by targeted amplicon sequencing of 24 genes. Acta Paediatrica, 109(12), 2636-2640.

Goian, C., & Breaz M. A. (2020). Children's opinion on conditions in day care centers. Revista Universitară de Sociologie, XVI(1), 71-82.

Goldwater, P. N., Kelmanson, I. A., & Little, B. B. (2020). Increased thymus weight in sudden infant death syndrome compared to controls: The role of sub-clinical infections. American Journal of Human Biology, 145(1), e23528,

Hashiyada, M., Obayashi, M., Matsumoto, T., Yoshimura, S., & Akane, A. (2019). Epigenome-wide association study for sudden unexpected infant death. Forensic Science International Genetics Supplement Series, 7(1), 818-819.

Jorch, G., Jorch, G., Tapiainen, T., Bonhoeffer, J., Fischer, T. K., Heininger, U., Hoet, B., Kohl, K. S., Lewis, E. M., Meyer, C., Nelson, T., Sandbu, S., Schlaud, M., Schwartz, A., Varricchio, F., & Wise, R. P. (2007). Unexplained sudden death, including sudden infant death syndrome (SIDS), in the first and second years of life. Vaccine, 25(31), 5707-5716.

Kiechl-Kohlendorfer, U., Hof, D., Peglow, U. P., Traweger-Ravanelli, B., & Kiechl, S. (2005). Epidemiology of apparent life threatening events. Archives of disease in childhood, 90(3), 297–300.

Kingsmore, S. F., Henderson, A., Owen, M. J., Clark, M. M., Hansen, C., Dimmock, D., Chambers, C. D., Jeliffe-Pawlowski, L. L., & Hobbs, C. (2020). Measurement of genetic diseases as a cause of mortality in infants receiving whole genome sequencing. NPJ GENOMIC MEDICINE, 5, 49.

Koeffer, J., Scheiper-Welling, S., Verhoff, M. A., Bajanowski, T., & Kauferstein, S., (2020). Post-mortem genetic investigation of cardiac disease-associated genes in sudden infant death syndrome (SIDS) cases. International Journal Of Legal Medicine.

Kon, F. C., Vazquez, R. Z., Lang A., & Cohen M. C. (2020). Hippocampal abnormalities and seizures: a 16-year single center review of sudden unexpected death in childhood, sudden unexpected death in epilepsy and SIDS. Forensic Science Medicine And Pathology, 16(3), 423-434.

Krous, H. F., Beckwith, J. B., Byard, R. W., Rognum, T. O., Bajanowski, T., Corey, T., Cutz, E., Hanzlick, R., Keens, T. G., & Mitchell, E. A. (2004). Sudden infant death syndrome and unclassified sudden infant deaths: a definitional and diagnostic approach. Pediatrics, 114(1), 234-238.

Krous, H. F., Haas, E. A., Masoumi, H., Chadwick, A. E., & Stanley, C. (2007). A comparison of pulmonary intra-alveolar hemorrhage in cases of sudden infant death due to SIDS in a safe sleep environment or to suffocation. Forensic Science International, 172(1), 56-62.

Lavezzi, A. M., Mehboob, R., Alfonsi, G., & Ferrero, S. (2020). Substantia Nigra Abnormalities Provide New Insight on the Neural Mechanisms Underlying the Sleep-Arousal Phase Dysfunctions in Sudden Infant Death Syndrome. American Society for Neurochemistry, 0, 1-13.

Lavista Ferres, J. M., Anderson, T. M., Johnston, R., Ramirez J-M., Mitchell, E. A. (2020). Distinct Populations of Sudden Unexpected Infant Death Based on Age. Pediatrics, 145(1), e20191637.

Luijerink, L. L. M., Vivekanandarajah, A., Waters, K. A., & Machaalani, R. (2020). The alpha 7 and beta 2 nicotinic acetylcholine receptor subunits regulate apoptosis in the infant hippocampus, and in sudden infant death syndrome (SIDS). APOPTOSIS, 25(7-8), 574-589.

Lupu, V. V., Ignat, A., Stoleriu, G., Ciubara, A. B., Ciubara, A., Lupu, V., Burlea, M., & Stratciuc, S. (2017). Vaccination of Children in Romania between Civic Obligation and Personal Choice. Revista De Cercetare Si Interventie Sociala, 56, 123-132.

Mahat-Shamir, M. (2020). Neither here nor there and a little bit of both: The ambiguous loss experience of parents who lost a baby to sudden infant death syndrome. Death Studies.

McGovern, M. C., & Smith, M. B. H. (2004). Causes of apparent life-threatening events in infants: a systematic review. Archives of Disease in Childhood, 89(11), 1043–1048.

Merino, A. M., Oliva-Navarro, J., Naranjo-Castresana, M., Aguilar, A-P. M. J., Herraez-Sanchez, E., Pastor-Romero, B., Sanchez-Tornero, M., Martinez-Bermejo, A. (2020). Could polysomnography identify potential SIDS/BRUE victims? Subtle changes in arousability during sleep in healthy infants (SIDS: Sudden infant death syndrome, BRUE: Brief Resolved Unexplained Event). Journal Of Sleep Research, 29 (supplement 1), 113.

Müller-Nordhorn, J., Schneider, A., Grittner, U., Neumann, K., Keil, T., Willich, S. N., & Binting, S. (2020). International time trends in sudden unexpected infant death, 1969–2012. BMC Pediatr, 20, 377.

Osawa, M., Ueno, Y., Ikeda, N., Ikematsu, K., Yamamoto, T., Irie, W., Kozawa, S., Kotani, H., Hamayasu, H., Murase, T. Shingu, K., Sugimoto, M., Nagao, R., & Kakimoto, Y. (2020). Circumstances and factors of sleep-related sudden infancy deaths in Japan. PLOS ONE, 15(8), e0233253.

Rini, S., Dhruv, G., & Deepak, K. (2016). Apparent Life-Threatening Events: An Overview. Clinical Pediatrics, 55(1), 5–9.

Ruiz-Botia, I., Cassanello-Peñarroya, P., Díez-Izquierdo, A., Martínez-Sánchez, J. M., & Balaguer-Santamaria, A. (2020). Sudden infant death syndrome: Do the parents follow the recommendations? Anales De Pediatria, 92(4), 222-228.

Sanchez, T., Peirano, D., Pipino, C., & Brockmann, P. E. (2020). Bad sleeping habits in infants: risk factor for sudden infant death syndrome. Pilot study. Revista Chilena De Pediatria-Chile, 91(4), 529-535.

Sandu, A. (2020). Bioethics – Philosophy or science?. Logos Universality Mentality Education Novelty: Philosophy & Humanistic Sciences, 8(1), 44-60.

Shipstone, R. A., Young, J., Kearney, L., & Thompson, J. M. D. (2020). Prevalence of risk factors for sudden infant death among Indigenous and non-Indigenous people in Australia. Acta Paediatrica, 109(12), 2614-2626.

Shipstone, R. A., Young, J., Thompson, J. M. D., & Byard, R. W. (2020). An evaluation of pathologists' application of the diagnostic criteria from the San Diego definition of SIDS and unclassified sudden infant death. International Journal Of Legal Medicine, 134(3), 1015-1021.

Sontag, J. M., Singh, B., Ostfeld, B. M., Hegyi, T., Steinberg, M. B., & Delnevo, C. D., (2020). Obstetricians' and Gynecologists' Communication Practices around Smoking Cessation in Pregnancy, Secondhand Smoke and Sudden Infant Death Syndrome (SIDS): A Survey. International Journal Of Environmental Research And Public Health, 17(8), 1-10.

Tieder, J. S., Bonkowsky, J. L., Etzel, R. A., Franklin, W. H., Gremse, D. A., Herman, B., Katz, E. S., Krilov, L. R., Merritt II, J. L., Norlin, C., Percelay, J., Sapien, R. E., Shiffman, R. N., & Smith, M. B. H. (2016). Brief Resolved Unexplained Events (Formerly Apparent Life-Threatening Events) and Evaluation of Lower-Risk Infants. Pediatrics, 137(5), e2 0160590.

Vennemann, M. M. T., Hoffgen, M., & Bajanowski, T., & Mitchell, E. A. (2007). Doimmunizations reduce the risk for SIDS? A meta-analysis. Vaccine, 25, 4875-4879.




How to Cite

Iov, T. ., Furnică, C. ., David, S. M. ., & Bulgaru-Iliescu, D. . (2020). Medical, Forensic and Social Quandaries of Sudden Infant Death Syndrome Today. BRAIN. Broad Research in Artificial Intelligence and Neuroscience, 11(3Sup1), 20-30.

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