Paediatric and perinatal deaths by the Office of the Irish State Pathologists: a 5-year retrospective cohort study
Danielle Moran1, Michael J Barrett2,3,4,5,6, Heidi Okkers7
1School of Medicine, RCSI, Dublin, Ireland daniellemoran21@rcsi.ie.
Insights
Homicide was the leading cause of referred paediatric and perinatal deaths to Ireland's Office of the State Pathologist (OSP). While reporting standards are high, improvements are needed for sudden infant death syndrome (SIDS) and pathologist collaboration.
Area of Science:
- Forensic Pathology
- Paediatric and Perinatal Mortality Review
Background:
- The Irish Office of the State Pathologist (OSP) handles forensic pathology for criminal, suspicious, or unusual deaths.
- This study reviews paediatric and perinatal deaths referred to the OSP.
Purpose of the Study:
- To review paediatric and perinatal deaths referred to the OSP.
- To compare findings against existing standards and data.
- To identify areas for service improvement.
Main Methods:
- Retrospective cohort study of paediatric and perinatal cases (<18 years) referred to the OSP (2018-2022).
- Review of postmortem examination (PME) reports against Royal College of Pathologists guidance.
- Analysis of case data alongside previous data (2012-2017).
Main Results:
- 65 cases identified; homicide was the leading cause (31%).
- Sudden Infant Death Syndrome (SIDS) was a key cause in infants under 1 year.
- 91% of PME reports met standards, but inconsistencies noted in SIDS reporting and anthropometric values.
- Referral rates remained consistent; variations observed between forensic and paediatric/perinatal pathologists' reports.
Conclusions:
- Homicide remains the leading cause of referred paediatric and perinatal deaths.
- The OSP provides a high standard of service, with key areas for improvement including SIDS reporting, anthropometric data, and pathologist collaboration.
- A single reporting database could enhance child mortality data analysis in Ireland.
Introduction:
The Irish Office of the State Pathologist (OSP) provides a forensic pathology service for cases of criminal, suspicious or unusual deaths as referred by the coroner. This study aims to review the paediatric and perinatal deaths referred to the OSP and compare them to existing standards and data.
Methods:
A retrospective cohort study was conducted on all paediatric and perinatal cases (<18 years) referred to the OSP from 2018 to 2022. Postmortem examination (PME) reports were reviewed in line with the Royal College of Pathologists guidance. Case data results were then analysed independently and alongside previously published data for 2012-2017.
Results:
65 cases were identified. Confirmed homicide accounted for the highest proportion of referred cases at 31% (n=20). Sudden infant death syndrome (SIDS) was the key cause under 1 years old (n=10/13). 91% of postmortem reports (2018-2022) met reporting standards. Paediatric and perinatal referrals remained consistent when comparing 2012-2017 to 2018-2022. Areas of inconsistency were in the area of SIDS and the inclusion of anthropometric reference values. PMEs involving forensic pathologists (FPs) and paediatric/perinatal pathologists (PPs) produced variations in reporting.
Conclusion:
Homicide was the leading cause of referred cases at 31% over 2018-2022 and 29% between 2012-2022. While the OSP provides a high standard service, key areas of improvement include the reporting of SIDS, the anthropometric reference values and the integration of PP and FP reports. Analysis of child mortality data and statistics in Ireland would be improved with the implementation of a single reporting database.
