PhD defence A.M. (Annelotte) Pries

Below is a brief summary of the dissertation: 

The sudden and unexpected death of a child is a devastating event. Understanding why it happened can bring closure to families, help doctors learn, and even prevent future tragedies. In the Netherlands, these deaths are investigated using the PESUDIC procedure (Postmortem Evaluation of Sudden Unexpected Death in Infants and Children), a national protocol that combines medical history, physical examination, laboratory and imaging tests, and autopsy results discussed by a multidisciplinary team.

Between 2016 and 2022, 212 children were examined through PESUDIC. A definite cause of death was found in 58% of cases and a probable one in 13%. Most deaths were caused by infections—especially group A streptococcal infections—followed by heart diseases. In nearly a quarter of the cases, doctors identified factors that might have been modifiable. Parents generally valued the procedure because it offered clarity and answers.

Further studies showed that in half of the cases with an autopsy performed, the autopsy was decisive for determining the cause of death. Microbiological testing and whole-body imaging were also frequently useful. Genetic testing helped explain some cases where no other cause was found.

Overall, this thesis shows that a comprehensive, structured investigation after sudden child deaths—combining medical, imaging, microbiological, and genetic approaches—provides crucial insights for families, supports public health surveillance, and helps identify opportunities for prevention.