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September 1, 1989

Autopsy and Diagnosing SIDS

Author Affiliations

Brooklyn, NY

Brooklyn, NY

JAMA. 1989;262(9):1184-1185. doi:10.1001/jama.1989.03430090046020

To the Editor. —  Allen et al1 make one assumption concerning postneonatal sudden infant death with which I do not agree. They assume that sudden infant death syndrome (SIDS) can be verified by autopsy. However, SIDS is an exclusionary diagnosis that requires careful death-scene investigation.2 There are no shortcuts; the investigation should include an on-site environmental assessment. Unfortunately, the authors did not collect detailed deathscene information on the circumstances surrounding death in the SIDS cases. The source of the SIDS diagnosis in their small study was frequently death certificate data.3The Georgia Post-Mortem Examination Act allows medical examiners to perform autopsies and conduct deathscene investigations on infants who die presumptively of SIDS. It is surprising that, with the great advances in neonatal survival in Georgia and with the tremendous cost in the intensive care of critically ill newborns, nearly half of the infants in this study who