Sudden unexpected neonatal death in the first week of life: autopsy findings from a specialist centre.
OBJECTIVE
Sudden unexpected early neonatal death (SUEND) in the first week of life shares features with sudden unexpected death in infancy (SUDI) but is not included as SUDI, which is limited to post-perinatal deaths. The aim of this study was to review SUEND autopsies performed in a single specialist centre over a 10-year period, (1996-2005).


METHODS
Retrospective analysis of >1500 consecutively performed paediatric autopsies performed by paediatric pathologists at one centre conducted according to a standard protocol including ancillary investigations. SUENDs were identified and autopsy findings reviewed.


RESULTS
Of 1516 post-mortem examinations, 180 were first-week neonatal deaths, 55 (31%) presenting as SUEND. Thirty-two (58%) were explained following autopsy, whilst the remainder were unexplained; most deaths during sleep were associated with adult co-sleeping. Around 40% of explained deaths were associated with undiagnosed congenital abnormalities, mainly congenital heart disease. In addition, there were nine infection-related deaths and three deaths from unsuspected metabolic disease (fatty acid oxidation defects).


CONCLUSIONS
There are distinct differences between SUEND and SUDI, with significantly more explained deaths in the former and a much greater proportion due to congenital abnormalities and metabolic disease.
Weber
Martin A
MA
Department of Paediatric Pathology, Great Ormond Street Hospital for Children, London, UK.
Ashworth
Michael T
MT
Risdon
R Anthony
RA
Brooke
Ivan
I
Malone
Marian
M
Sebire
Neil J
NJ
D000367:Age Factors; D001344:Autopsy; D002423:Cause of Death; D006801:Humans; D007231:Infant, Newborn; D012189:Retrospective Studies; D013038:Specialization; D013398:Sudden Infant Death / Q000453:epidemiology / Q000473:pathology*