A Boston University pathologist says spinal injury during or after birth may be the unknown cause of thousands of sudden unexpected infant deaths.

The Public Health Service estimates that 12,000 to 25,000 such deaths occur in the United States every year. In most cases, apparently normal babies are found dead in their cribs.

Although autopsies attribute such deaths to pneumonia, infection, suffocation and other conditions, the underlying cause is obscure.

In a speech Friday to the American Association of Pathologists and Bacteriologists, Dr. Abraham Towbin said that spinal structures are not routinely examined in infant autopsies.

He told the group that after examining the spinal structures of all infants on which he performed autopsies last year, he found evidence of spinal injury in seven of eight cases of unexplained crib deaths. He said the injury took the form of hemorrhage around the spinal cord.

He explained that spinal hemorrhage is not fatal in itself but that suppression of the cord's vital functions cause fatal paralysis of respiration.

"Manifestly, not only during delivery, but also after birth, the vertebral structures of the neck are subject to sudden strain and injury," he said. "In the young infant, the head is large and heavy, making up approximately one fourth of the body weight.

"Structurally, the young infant is top heavy; the infant's head, in proportion to body weight is four times as heavy as that of the adult. From these considerations emerges a prospective basis for the pathogenesis of spinal injury in young infants; with the heavy head pivoted atop the frail weak cervical spine, the small infant is vulnerable to self-injury," he said.

REPRINT FROM SPARTANBURG S.C. JOURNAL

3/2/68

COURTESY OF: PAUL GARTENSLEBEN