{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T02:37:30Z","timestamp":1777862250987,"version":"3.51.4"},"reference-count":28,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2012,3,1]],"date-time":"2012-03-01T00:00:00Z","timestamp":1330560000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J R Soc Med"],"published-print":{"date-parts":[[2012,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Infant mortality has undergone a dramatic reduction in the UK over the past century because of improvements in public health policy and medical advances. Postmortem examinations have been performed at Great Ormond Street Hospital for over 100 years, and analysis of cases across this period has been performed to assess changing patterns of infant deaths undergoing autopsy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Autopsy reports from 1909 and 2009 were examined. Age, major pathology and cause of death was reviewed from these cases and entered into an anonymized database. A subsequent comparative analysis was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>All postmortems performed and reported at Great Ormond Street Hospital in 1909 and 2009.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Infant deaths, aged 0\u2013365 days, were identified and subsequently analysed for the two years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Comparative proportional analysis of postmortem findings from the two time periods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Three-hundred and fifty-seven and 347 autopsy reports were identified from 1909 and 2009 including 178 and 128 infant deaths, respectively. The commonest cause of death in 1909 was infection (74%) compared to 20% of deaths in 2009. The most frequent final \u2018diagnosis\u2019 in 2009 was \u2018unexplained sudden unexpected infant death (SUDI)\u2019, despite a full postmortem including ancillary investigations. In contrast, there were no such cases recorded in 1909, but there were frequent deaths due to gastroenteritis and malnutrition together accounting for 16% of cases, compared to one case of gastroenteritis in 2009. Fifteen percent of 1909 cases had infections which are almost never fatal with appropriate treatment in 2009, including tuberculosis, diphtheria and syphilis. Congenital anomalies were detected with similar frequencies at both time points, (21% and 19% in 1909 and 2009, respectively).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In the UK, significant changes in patterns of pathology have occurred in paediatric autopsy cases performed at a single specialist centre. Fatal infections and malnutrition (both poverty-related) have reduced yet the incidence of congenital anomalies has remained similar.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1258\/jrsm.2011.110075","type":"journal-article","created":{"date-parts":[[2012,3,20]],"date-time":"2012-03-20T11:38:38Z","timestamp":1332243518000},"page":"123-130","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Changing patterns of infant death over the last 100 years: autopsy experience from a specialist children's hospital"],"prefix":"10.1258","volume":"105","author":[{"given":"JW","family":"Pryce","sequence":"first","affiliation":[{"name":"UCL Institute of Child Health, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"MA","family":"Weber","sequence":"additional","affiliation":[{"name":"Department of Paediatric Pathology, Great Ormond Street Hospital for Children, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"MT","family":"Ashworth","sequence":"additional","affiliation":[{"name":"Department of Paediatric Pathology, Great Ormond Street Hospital for Children, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"SEA","family":"Roberts","sequence":"additional","affiliation":[{"name":"UCL Institute of Child Health, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Malone","sequence":"additional","affiliation":[{"name":"Department of Paediatric Pathology, Great Ormond Street Hospital for Children, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"NJ","family":"Sebire","sequence":"additional","affiliation":[{"name":"UCL Institute of Child Health, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2012,3,20]]},"reference":[{"key":"bibr-JRSM-11-0075C1","unstructured":"University of California (USA), Max Planck Institute for Demographic Research (Germany). Human mortality database. See www.mortality.org (last checked 1 February 2011)"},{"key":"bibr-JRSM-11-0075C2","unstructured":"Office for National Statistics.\n                      Postneonatal and childhood deaths in 2008\n                      . See http:\/\/www.statistics.gov.uk\/downloads\/theme_health\/child-mortality\/child-mort-stats08.pdf. (last checked 1 February 2011)"},{"key":"bibr-JRSM-11-0075C3","doi-asserted-by":"publisher","DOI":"10.1017\/CBO9781316036495.004"},{"key":"bibr-JRSM-11-0075C4","unstructured":"SouthallH. A vision of Britain through time. See www.visionofbritain.org.uk (last checked 1 February 2011)"},{"key":"bibr-JRSM-11-0075C5","first-page":"11","volume-title":"The Remarkable Story of Great Ormond Street Hospital","author":"Telfer K","year":"2008"},{"key":"bibr-JRSM-11-0075C6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2009.05.013"},{"key":"bibr-JRSM-11-0075C7","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60946-6"},{"key":"bibr-JRSM-11-0075C8","doi-asserted-by":"publisher","DOI":"10.1006\/exmp.2001.2371"},{"key":"bibr-JRSM-11-0075C9","volume-title":"Sudden unexpected deaths in infancy. A multi-agency protocol for care and investigation","author":"The Royal College of Pathologists and The Royal College of Paediatrics and Child Health","year":"2004"},{"key":"bibr-JRSM-11-0075C10","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.56.7.537"},{"key":"bibr-JRSM-11-0075C11","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2002.012740"},{"key":"bibr-JRSM-11-0075C12","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.40.2.180"},{"key":"bibr-JRSM-11-0075C13","doi-asserted-by":"publisher","DOI":"10.1177\/0363199009344692"},{"key":"bibr-JRSM-11-0075C14","doi-asserted-by":"publisher","DOI":"10.1080\/00324720903362806"},{"key":"bibr-JRSM-11-0075C15","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2010.159863"},{"key":"bibr-JRSM-11-0075C16","doi-asserted-by":"publisher","DOI":"10.1016\/0277-9536(92)90330-S"},{"key":"bibr-JRSM-11-0075C17","unstructured":"Prevention of cruelty to, and protection of, children act, 1889. See http:\/\/www.legislation.gov.uk\/ukpga\/1889\/44\/pdfs\/ukpga_18890044_en.pdf (last checked 24 February 2011)"},{"key":"bibr-JRSM-11-0075C18","first-page":"1","volume-title":"Sudden Infant Death Syndrome: Problems, progress and possibilities","author":"Byard RW","year":"2001"},{"key":"bibr-JRSM-11-0075C19","doi-asserted-by":"publisher","DOI":"10.1007\/BF01953930"},{"key":"bibr-JRSM-11-0075C20","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)60798-9"},{"key":"bibr-JRSM-11-0075C21","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2009.158352"},{"key":"bibr-JRSM-11-0075C22","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.2009.01611.x"},{"key":"bibr-JRSM-11-0075C23","doi-asserted-by":"publisher","DOI":"10.1016\/j.resp.2007.05.014"},{"key":"bibr-JRSM-11-0075C24","doi-asserted-by":"publisher","DOI":"10.1002\/dev.20367"},{"key":"bibr-JRSM-11-0075C25","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.49.12.965"},{"key":"bibr-JRSM-11-0075C26","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2009.165704"},{"key":"bibr-JRSM-11-0075C27","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-010-1261-0"},{"key":"bibr-JRSM-11-0075C28","doi-asserted-by":"publisher","DOI":"10.1016\/j.legalmed.2009.01.066"}],"container-title":["Journal of the Royal Society of Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1258\/jrsm.2011.110075","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1258\/jrsm.2011.110075","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1258\/jrsm.2011.110075","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T05:09:07Z","timestamp":1777525747000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1258\/jrsm.2011.110075"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,3]]},"references-count":28,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2012,3]]}},"alternative-id":["10.1258\/jrsm.2011.110075"],"URL":"https:\/\/doi.org\/10.1258\/jrsm.2011.110075","relation":{},"ISSN":["0141-0768","1758-1095"],"issn-type":[{"value":"0141-0768","type":"print"},{"value":"1758-1095","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,3]]}}}