Infant deaths due to unintentional injury. An 11-year autopsy review

T. S. Corey, L. C. McCloud, G. R. Nichols 2nd and J. J. Buchino
Department of Pathology, University of Louisville School of Medicine, KY.

OBJECTIVE--The number and causes of unintentional infant deaths were determined to identify common, preventable infant deaths. DESIGN--Retrospective autopsy review. SUBJECTS--Infants aged 1 day to 1 year undergoing complete autopsies. SETTING--Autopsies performed by the Louisville Office of the Kentucky Medical Examiner's Program from 1979 through 1989. METHOD--The manner of death was designated as an "accident" based on review of autopsy findings, scene investigation, and investigation by law enforcement officials. The cases were divided into groups based on the nature of the unintentional injury. RESULTS--Causes of death included asphyxia in mechanically unsafe sleeping environments, overlying, drowning, scald burns, plastic bag suffocation, house fires, motor vehicle collisions, aspiration of foreign bodies, hypothermia, blunt head trauma, and alcohol toxicity. The largest group of deaths in this series resulted from mechanically unsafe sleeping environments. CONCLUSIONS--The majority of deaths in this series could have been prevented by minor changes in the household environment. The causes of fatal unintentional injury to infants are different from those in older children. Pediatricians should be aware of hazards unique to this age group.