Lung development: Number of terminal bronchiolar duct endings and gas exchange surface area in victims of sudden infant death syndrome

Previous research has demonstrated impaired renal development, particularly with respect to glomerular number, in victims of sudden infant death syndrome (SIDS). The present study used stereological principles to estimate the volume of the upper lobe of the right lung, total number of terminal bronchiolar duct endings (TBDE), and gas exchange surface area of this lobe within a group of human infants. The infants were classified according to cause of death (SIDS or non‐SIDS), and further subdivided according to birth‐weight: normal birth‐weight (NBW) or low birth‐weight (LBW). The results demonstrated that TBDE density was significantly reduced in SIDS compared to non‐SIDS (P = 0.014), but only reduced from non‐SIDS NBW values in the SIDS NBW group (P = 0.044). Total TBDE number was significantly reduced in SIDS from non‐SIDS (P = 0.001), and was significantly reduced from non‐SIDS NBW values in SIDS NBW (P = 0.023). Mean gas exchange surface area per TBDE was significantly increased in SIDS compared to non‐SIDS cases (P = 0.049). The results of the present study indicate developmental delay of the lung in SIDS NBW infants who had previously not been considered growth retarded based on their normal body parameters. Pediatr Pulmonol. 2001; 31:339–343. © 2001 Wiley‐Liss, Inc.