The pathology of cot death

Based on personal investigation of more than 2000 unexpected infant deaths it appears that 'cot deaths' do not form a pathological entity. This concept is supported by detailed pathological studies undertaken in a multicentre study of postperinatal mortality in the United Kingdom. Comprehensive necropsies were performed by paediatric pathologists on 519 infants including 293 whose death certificates indicated cot death. These 519 infants were examined for abnormalities of growth and development, metabolism and immunological status. Together with any evidence of atopy, and of old or recent tissue damage, a summation of disease present was obtained. Examined in this way the author believes that an explanation can be given for almost as many unexpected deaths as for deaths that occur in hospital, that is, are expected.