Infection as a predominant cause of perinatal mortality.
During a 15-month period, all 34 infants delivered at the department of obstetrics and gynecology at University Hospital in Lund, Sweden, who died perinatally or neonatally were included in a prospective study of causes of death. Autopsies--including extensive culturing of specimens for bacteria, chlamydia, fungi, mycoplasmas, and viruses--were performed for all infants. Maternal sera obtained during pregnancy and after delivery were examined regarding titers against a number of microorganisms. During the study period, the perinatal mortality rate was 0.60% and the neonatal mortality rate 0.56%. It was found that 37% of the deaths were caused by lethal malformations, 17% by idiopathic respiratory distress syndrome, and 9% by ablatio placentae. However, no less than 21% occurred as a direct consequence of infections, including 2 deaths caused by group B streptococci, 2 by Coxsackie B virus, and 3 deaths each by Hemophilus influenzae, Pseudomonas pyocyanea, and Candida albicans. A 6-month study of late abortions revealed another case of intrauterine group B streptococcal infection. The study has demonstrated that autopsy, including microbial examination, is recommended in all cases of perinatal and neonatal deaths.
D000031:Abortion, Septic; D000328:Adult; D000013:Congenital Abnormalities / Q000401:mortality; D003384:Coxsackievirus Infections / Q000401:mortality; D029822:Enterovirus B, Human; D005260:Female; D005313:Fetal Death / Q000209:etiology*; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000401:mortality*; D007239:Infections / Q000401:mortality*; D008297:Male; D010920:Placenta / Q000382:microbiology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D011446:Prospective Studies; D012127:Respiratory Distress Syndrome, Newborn / Q000401:mortality; D013290:Streptococcal Infections / Q000401:mortality; D013292:Streptococcus agalactiae; D013548:Sweden