Shipstone Rebecca, Thompson John M D, Young Jeanine, Byard Roger W
School of Nursing, Midwifery, and Paramedicine, University of the Sunshine Coast, Sippy Downs, Queensland, Australia.
Faculty of Medical and Health Science, Departments of Paediatrics, Child and Youth Health, and Obstetrics and Gynaecology, University of Auckland, Auckland, New Zealand.
Acta Paediatr. 2020 Jun;109(6):1162-1165. doi: 10.1111/apa.14834. Epub 2019 May 27.
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.
比较婴儿猝死综合征（SUDI）中父母报告的发现时的体位与尸检报告中的尸斑情况，并更准确地对婴儿睡眠体位进行分类。
回顾2010年至2014年昆士兰州的SUDI病例，以确定报告中婴儿被放置及发现时的体位。将其与尸检时尸斑的分布情况进行比较。还记录了早期死亡现场调查时存在尸斑的证据。
在228例SUDI中有22例（9.6%）报告的婴儿被发现时的体位与尸检时尸斑的体位不一致。尽管据报告13例婴儿被发现为仰卧位、3例为侧卧位、6例体位不明，但所有婴儿尸斑均在身前。使用尸检时身前尸斑来改变发现时的体位，使俯卧位婴儿的比例从37.7%增加到47.4%。在47.8%的病例中，现场报告的身前或身侧尸斑在尸检时已不存在。
先前公布的优势比可能低估了俯卧睡眠体位与婴儿猝死相关的风险。SUDI死亡现场调查方案应要求在运送婴儿前对尸斑进行拍照记录。
