Central nervous system damage as a possible component of unexpected deaths in infancy.
A longitudinal study of 1553 infants, designed to provide early indicators of gross developmental problems by using a behavioral assessment scale, included 12 infants who later died suddenly and unexpectedly. In a retrospective examination of neonatal records, considerable evidence of central nervous system damage was found. Anoxic conditions and even possible seizure activity were implicated. Abnormalities of muscle tonus, skin color and cry were found, together with some visual problems. These findings on behavioral assessment in the neonatal period appear to identify a population which is at greater risk of sudden death in infancy. The need for oxygen therapy as a high-risk indicator of sudden unexpected death has been reported in a previous study and is further substantiated by the present findings: they are also compatible with thos of Naeye (1973), who found long-term hypoxic conditions in autopsy studies on the sudden infant death syndrome. It is suggested that the possibility of central nervous system involvement in the aetiology of the sudden infant death syndrome should be more thoroughly investigated.