The Office of the Chief Medical Examiner (
OCME) has recorded a significant decline in the deaths of
sudden infant death syndrome (
SIDS) in the state of Maryland since 1994. However, infants who died of accidental or non-
accidental injuries remained consistent during the same time period. This report focuses on the epidemiological characteristics and scene investigation findings of infant victims who died suddenly and unexpectedly in Maryland between 1990 and 2000. A retrospective study of
OCME cases between 1990 and 2000 yielded a total of 1619 infant fatalities. 802
infant deaths were determined to be
SIDS, which represented 50% of the total
infant deaths in our study population. Five hundred and twenty-three (31.8%) deaths were due to natural diseases, 128 (7.9%) deaths were accidents, and 74 (4.6%) were homicides. The manner of death could not be determined after a thorough scene investigation, review of history and a complete postmortem examination in 92 (5.7%) infants.
SIDS deaths most often involved infants who were male and black. The peak incidence of
SIDS was between 2 and 4 months of age. The majority of
SIDS infants (60%) were found unresponsive on their stomach. Among
SIDS infants, 269 (33.4%) were found in bed with another person or persons (bed sharing). Of the bed-sharing
SIDS cases, 182 (68%) were African-American. In the past 11 years, 52 infants died of
asphyxia due to unsafe sleeping environment, such as defective
cribs, ill-fitting mattresses, inappropriate bedding materials. Of the 74 homicide victims, 53 (70%) involved infants less than 6 months of age. Twenty (27%) exhibited the classical abuse syndrome characterized by repeated acts of
trauma to the infants.