title: Investigation of sudden infant deaths in the State of Maryland (1990-2000).
abstract: The Office of the Chief Medical Examiner (OCME) has recorded a significant decline in the deaths of sudden infant death syndrome (SIDS) in the state of Maryland since 1994. However, infants who died of accidental or non-accidental injuries remained consistent during the same time period. This report focuses on the epidemiological characteristics and scene investigation findings of infant victims who died suddenly and unexpectedly in Maryland between 1990 and 2000. A retrospective study of OCME cases between 1990 and 2000 yielded a total of 1619 infant fatalities. 802 infant deaths were determined to be SIDS, which represented 50% of the total infant deaths in our study population. Five hundred and twenty-three (31.8%) deaths were due to natural diseases, 128 (7.9%) deaths were accidents, and 74 (4.6%) were homicides. The manner of death could not be determined after a thorough scene investigation, review of history and a complete postmortem examination in 92 (5.7%) infants. SIDS deaths most often involved infants who were male and black. The peak incidence of SIDS was between 2 and 4 months of age. The majority of SIDS infants (60%) were found unresponsive on their stomach. Among SIDS infants, 269 (33.4%) were found in bed with another person or persons (bed sharing). Of the bed-sharing SIDS cases, 182 (68%) were African-American. In the past 11 years, 52 infants died of asphyxia due to unsafe sleeping environment, such as defective cribs, ill-fitting mattresses, inappropriate bedding materials. Of the 74 homicide victims, 53 (70%) involved infants less than 6 months of age. Twenty (27%) exhibited the classical abuse syndrome characterized by repeated acts of trauma to the infants.
authors.affiliation: Office of the Chief Medical Examiner, State of Maryland, 111 Penn Street, Baltimore, MD 21201, USA. ling001@aol.com
authors.forename: Ling
authors.initials: L
authors.lastname: Li
authors.forename: David
authors.initials: D
authors.lastname: Fowler
authors.forename: Liang
authors.initials: L
authors.lastname: Liu
authors.forename: Mary G
authors.initials: MG
authors.lastname: Ripple
authors.forename: Zoe
authors.initials: Z
authors.lastname: Lambros
authors.forename: John E
authors.initials: JE
authors.lastname: Smialek
mesh_terms: D000061:Accidents, Home / Q000401:mortality; D017677:Age Distribution; D001237:Asphyxia / Q000401:mortality; D001513:Beds; D002423:Cause of Death; D002649:Child Abuse / Q000706:statistics & numerical data; D005260:Female; D005554:Forensic Medicine; D006708:Homicide / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D015370:Infant Equipment; D008297:Male; D008396:Maryland / Q000453:epidemiology; D016684:Prone Position; D012189:Retrospective Studies; D013398:Sudden Infant Death / Q000453:epidemiology* / Q000208:ethnology; D016683:Supine Position