Byard Roger W, Shipstone Rebecca A, Young Jeanine
School of Medicine, The University of Adelaide and Forensic Science SA, Adelaide, SA, 5000, Australia.
School of Nursing Midwifery and Paramedicine, University of the Sunshine Coast, Queensland, Australia.
J Forensic Leg Med. 2019 May;64:20-22. doi: 10.1016/j.jflm.2019.03.007. Epub 2019 Mar 16.
The classification of the cause of unexpected infant deaths by both pathologists and researchers may be quite inconsistent. For example, if an infant is found lying face down on soft bedding the death may still be certified as 'sudden infant death syndrome (SIDS)', 'accidental suffocation', 'undetermined', 'unclassified sudden infant death (USID)', or 'sudden unexpected death in infancy (SUDI)'. As the San Diego definition of SIDS does not appear to be rigorously or consistently applied, clarifying 'mechanical asphyxia not determined with certainty' may help to more clearly separate SIDS from USID. Including a classification algorithm with the definition may also help to better define unsafe sleep factors and suffocation. This commentary reviews the current situation with regard to classifying these deaths and concludes that the absence of diagnostic pathological markers with conflicting classification systems has led to idiosyncratic certification practices.
病理学家和研究人员对意外婴儿死亡原因的分类可能存在很大差异。例如，如果发现一名婴儿脸朝下躺在柔软的床上用品上，死亡仍可能被认定为“婴儿猝死综合征（SIDS）”、“意外窒息”、“死因不明”、“未分类的婴儿猝死（USID）”或“婴儿期意外猝死（SUDI）”。由于圣地亚哥对SIDS的定义似乎没有得到严格或一致的应用，明确“无法确定的机械性窒息”可能有助于更清晰地将SIDS与USID区分开来。在定义中纳入分类算法也可能有助于更好地界定不安全睡眠因素和窒息情况。本评论回顾了这些死亡分类的现状，并得出结论，缺乏诊断性病理标志物以及相互冲突的分类系统导致了特殊的认证做法。
