Neonatal autopsies: a 10-year experience.
OBJECTIVE
To identify trends in neonatal autopsy rates at a tertiary care hospital during the last decade, to determine the concordance between antemortem and post-mortem diagnoses, and to describe patient characteristics that influenced diagnostic yield on autopsy.


METHODS
Retrospective review of medical records.


METHODS
Tertiary care children's hospital.


METHODS
All neonatal deaths between January 1, 1984, and December 31, 1993.


METHODS
For those with autopsies, data included length of stay, diagnostic imaging studies, antemortem diagnoses, and autopsy findings. Autopsy diagnoses were compared with antemortem findings and classified according to concordance.


RESULTS
Of 487 neonatal deaths, autopsies were performed in 296 (61%). The autopsy rate declined significantly during 10 years from 71.2% (1984-1988) to 47.7% (1989-1993). New diagnoses were made at autopsy in 44% of cases. Major discordancies were identified in 35 infants (12%); minor discordancies in 95 (32%). Autopsies were more likely to reveal new diagnoses in infants born at 28 to 36 weeks' gestation and in those whose mothers had no prenatal care. Major findings at autopsy were more likely in infants whose mothers had no prenatal care and in infants who died within 6 hours of birth. There was no relationship between new findings at autopsy and age, length of hospital stay, or antemortem imaging studies.


CONCLUSIONS
This study reveals a significant decline in neonatal autopsies during a 10-year period. This study also demonstrates that neonatal autopsy continues to provide clinically significant data and remains a valuable tool in perinatal medicine.
Kumar
P
P
Department of Pediatrics, Lutheran General Children's Hospital, Park Ridge, Ill 60068, USA.
Angst
D B
DB
Taxy
J
J
Mangurten
H H
HH
D000328:Adult; D001344:Autopsy / Q000706:statistics & numerical data*; D002423:Cause of Death; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000401:mortality* / Q000473:pathology; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008423:Maternal Age; D011295:Prenatal Care