Sudden Unexpected Death in Infancy [SUDI]: What the clinician, pathologist, coroner and researchers want to know

Paediatr Respir Rev. 2022 Mar:41:14-20. doi: 10.1016/j.prrv.2021.08.002. Epub 2021 Aug 13.


The loss of an apparently healthy infant is confronting for any family, puzzling for a clinician and challenging for the pathologist charged with the task of demonstrating a cause for death. The term "cot death" evolved to "sudden infant death syndrome" [SIDS] and now "sudden unexpected death in infancy [SUDI]" as the epidemiology and pathology of infant death changed. Community interventions were successful in changing sleep practices for young babies. The current research focus is on understanding genetic predispositions to unexpected death in early childhood. Whilst much has been achieved in reducing the infant mortality rate from SUDI by between 50%, and 80% in some countries, over the last 30 years, there remain challenges for improving rates of accurate diagnosis and reaching out to more vulnerable families with clearly modifiable risk factors for SUDI. These challenges directly involve the clinician through taking a systematic and detailed history and better standardised death scene evaluations with specifically accredited assessors. Better knowledge regarding circumstances of SUDI cases will help Coroners and researchers provide answers for grieving families now, and in the future contribute to further reductions in the rate of SUDI in communities across the world.

Keywords: Court; Death scene investigation; Medical history; Pathology; Post-mortem examination; Sudden Unexplained Death in Infancy [SUDI].

Publication types

  • Review

MeSH terms

  • Child, Preschool
  • Coroners and Medical Examiners*
  • Humans
  • Infant
  • Pathologists
  • Risk Factors
  • Sleep
  • Sudden Infant Death* / epidemiology
  • Sudden Infant Death* / etiology