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Book contents

20 - A Scandinavian Perspective

Published online by Cambridge University Press:  20 July 2018

Torleiv Ole Rognum
Affiliation:
Section of Pediatric Forensic Medicine,Department of Forensic Sciences, Oslo University Hospital, Norway Department of Forensic Medicine, Division of Laboratory Medicine, University of Oslo, Norway
Åshild Vege
Affiliation:
Section of Pediatric Forensic Medicine,Department of Forensic Sciences, Oslo University Hospital, Norway Department of Forensic Medicine, Division of Laboratory Medicine, University of Oslo, Norway
Arne Stray-Pedersen
Affiliation:
Section of Pediatric Forensic Medicine,Department of Forensic Sciences, Oslo University Hospital, Norway Department of Forensic Medicine, Division of Laboratory Medicine, University of Oslo, Norway
Lillian Bøylestad
Affiliation:
Section of Pediatric Forensic Medicine,Department of Forensic Sciences, Oslo University Hospital, Norway
Jodhie R. Duncan
Affiliation:
University of Melbourne
Roger W. Byard
Affiliation:
University of Adelaide
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Summary

Introduction

In the 1980s, sudden infant death syndrome (SIDS) in Norway made up half of all post-neonatal deaths, and more than 80% of all sudden unexpected deaths during the first year after birth. As in most Western countries, the rate of SIDS in Scandinavian countries dropped dramatically after 1990 (the era of safe sleep campaigns). Before 1990 the police attended the death scene following a sudden death in an infant, as in all other cases of sudden unexpected deaths, regardless of age. Due to massive criticisms from parents who felt incriminated, the Prosecutor General in 1991 withdrew the police from the scene of death in infants. Since the diagnosis of SIDS requires performance of a death scene investigation, an initiative was necessary. This chapter discusses SIDS in Scandinavia and the issues faced regarding death scene investigations.

SIDS Epidemic

Of the Scandinavian countries, Norway and Denmark were most severely hit by the SIDS epidemic in the 1980s (1). In Sweden and Finland the epidemic was less dramatic (1). As in all Western countries, the “this side up” campaign led to a dramatic drop in the SIDS rate. In Norway the SIDS rate has dropped from 2.4 per 1,000 live-born to 0.15 per 1,000 live-born in 2016 (Figure 20.1).

The SIDS epidemic: Real or due to a diagnostic shift?

The question as to whether the dramatic reduction in SIDS rate might partly be due to a change in diagnostic practice has been ruled out in Norway. Looking at the total post-neonatal mortality, there was an increase during the 1980s and a decline during the 1990s, in parallel with the drop in SIDS rates (Figure 20.2).

The SIDS Diagnosis

Since SIDS is a diagnosis of exclusion (2), it is necessary to perform an extensive autopsy, including comprehensive histology, microbiology, X-ray examination, toxicology, genetic testing, and metabolic screening before concluding that SIDS is the cause of death. It is also mandatory to perform a death scene investigation. In Norway all of these diagnostic tools, in addition to a CT scan, are included. Full metabolic screening is not yet operative. We do, however, perform testing for medium-chain acyl-CoA dehydrogenase deficiency (MCAD) mutation, and plan to add full metabolic screening in the future. The result of the autopsy is discussed in an interdisciplinary case conference and the final diagnosis given. The case conference also discusses whether the death could have been prevented.

Type
Chapter
Information
SIDS Sudden Infant and Early Childhood Death
The past, the present and the future
, pp. 421 - 430
Publisher: The University of Adelaide Press
Print publication year: 2018

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  • A Scandinavian Perspective
    • By Torleiv Ole Rognum, Section of Pediatric Forensic Medicine,Department of Forensic Sciences, Oslo University Hospital, Norway Department of Forensic Medicine, Division of Laboratory Medicine, University of Oslo, Norway, Åshild Vege, Section of Pediatric Forensic Medicine,Department of Forensic Sciences, Oslo University Hospital, Norway Department of Forensic Medicine, Division of Laboratory Medicine, University of Oslo, Norway, Arne Stray-Pedersen, Section of Pediatric Forensic Medicine,Department of Forensic Sciences, Oslo University Hospital, Norway Department of Forensic Medicine, Division of Laboratory Medicine, University of Oslo, Norway, Lillian Bøylestad, Section of Pediatric Forensic Medicine,Department of Forensic Sciences, Oslo University Hospital, Norway
  • Edited by Jodhie R. Duncan, University of Melbourne, Roger W. Byard, University of Adelaide
  • Book: SIDS Sudden Infant and Early Childhood Death
  • Online publication: 20 July 2018
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  • A Scandinavian Perspective
    • By Torleiv Ole Rognum, Section of Pediatric Forensic Medicine,Department of Forensic Sciences, Oslo University Hospital, Norway Department of Forensic Medicine, Division of Laboratory Medicine, University of Oslo, Norway, Åshild Vege, Section of Pediatric Forensic Medicine,Department of Forensic Sciences, Oslo University Hospital, Norway Department of Forensic Medicine, Division of Laboratory Medicine, University of Oslo, Norway, Arne Stray-Pedersen, Section of Pediatric Forensic Medicine,Department of Forensic Sciences, Oslo University Hospital, Norway Department of Forensic Medicine, Division of Laboratory Medicine, University of Oslo, Norway, Lillian Bøylestad, Section of Pediatric Forensic Medicine,Department of Forensic Sciences, Oslo University Hospital, Norway
  • Edited by Jodhie R. Duncan, University of Melbourne, Roger W. Byard, University of Adelaide
  • Book: SIDS Sudden Infant and Early Childhood Death
  • Online publication: 20 July 2018
Available formats
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Send book to Google Drive

To send content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Google Drive.

  • A Scandinavian Perspective
    • By Torleiv Ole Rognum, Section of Pediatric Forensic Medicine,Department of Forensic Sciences, Oslo University Hospital, Norway Department of Forensic Medicine, Division of Laboratory Medicine, University of Oslo, Norway, Åshild Vege, Section of Pediatric Forensic Medicine,Department of Forensic Sciences, Oslo University Hospital, Norway Department of Forensic Medicine, Division of Laboratory Medicine, University of Oslo, Norway, Arne Stray-Pedersen, Section of Pediatric Forensic Medicine,Department of Forensic Sciences, Oslo University Hospital, Norway Department of Forensic Medicine, Division of Laboratory Medicine, University of Oslo, Norway, Lillian Bøylestad, Section of Pediatric Forensic Medicine,Department of Forensic Sciences, Oslo University Hospital, Norway
  • Edited by Jodhie R. Duncan, University of Melbourne, Roger W. Byard, University of Adelaide
  • Book: SIDS Sudden Infant and Early Childhood Death
  • Online publication: 20 July 2018
Available formats
×