HYPERTHERMIA IN SUDDEN INFANT DEATH

To determine whether preterminal hyperthermia is significantly associa ted with sudden infant death (SID), 140 structured interviews with par ents of SID victims were compared with questionnaires filled in by a c ontrol group of parents living in the same area. All SID autopsies wer e performed between 1986 and 1992 at the Institute of Legal Medicine o f Hannover Medical School according to the same protocol. Signs of pro fuse sweating (i.e. moist head, damp clothing or bedding) were present at the scene of death in 35.7% of cases. SID victims with signs of pr ofuse sweating were more frequently found under their bedding (p < 0.0 01), were older (178 vs. 130 days) and the time period between when th ey were last seen alive and when they were found dead was longer (6.5 vs. 4.5 hours p < 0.01) compared to cases without sweating. Sweat on t he head [odds ratio (OR) = 1.9; 95% confidence interval (CI)= 1.0, 3.6 ], and sweaty clothing and bedding (OR = 17.9; 95% CI = 8.7; 37.1) sho wed a significant association with the risk for SID. The pathophysiolo gical basis for hyperthermia in SID remains to be determined. Hyperthe rmia could result from infection, overinsulation from excessive clothi ng with high environmental temperatures, covering of the infant's head or immature central thermoregulatory centres. The influence on the fa tal outcome and the role in the pathogenesis of these deaths requires further research.