Perinatal and infant autopsy.
OBJECTIVE
To measure perinatal and infant autopsy rate in Wales over a 10-year period and study factors influencing the decision to perform an autopsy.


METHODS
Retrospective cohort analysis of data from the All Wales Perinatal Survey.


METHODS
Autopsy rates were calculated over a 10-year period (1994-2003), and reasons for not performing an autopsy were noted. Two time periods, 1994-1996 and 2001-2003 were compared, to study changing autopsy patterns.


RESULTS
Over the 10-year period, there were 4393 perinatal and infant deaths, with data available for 4306 (98%) cases. Consent for autopsy was requested in 89% of cases and granted in 68%. When compared, the 3-year cumulative autopsy rate fell from 67.5% (95% confidence interval (CI) 65% to 69%) in 1994-1996, to 52.7% (CI 49% to 55%) in 2001-2003. The difference in the proportion of autopsies performed between the two time periods was 14.8% (CI 11% to 18%). Parental consent was granted in 76.2% (CI 73% to 78%) of cases in 1994-1996 and 60% (CI 57% to 63%) of cases in 2001-2003. The difference in proportion in consent for autopsy in the two time periods was 16% (CI 12% to 20%).


CONCLUSIONS
A decrease in perinatal and infant autopsy rates has been found in Wales over the past 10 years. Parental refusal has been the main cause of this decline.
Adappa
R
R
Department of Child Health, Cardiff University, University Hospital of Wales, Cardiff, UK. roshanadappa@aol.com
Paranjothy
S
S
Roberts
Z
Z
Cartlidge
P H T
PH
D001344:Autopsy / Q000706:statistics & numerical data*; D003657:Decision Making; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D033282:Parental Consent / Q000706:statistics & numerical data; D018743:Perinatal Care / Q000639:trends*; D012189:Retrospective Studies; D014852:Wales / Q000453:epidemiology