title: The value of neonatal autopsy.
abstract: OBJECTIVE
  Neonatal autopsy rates were in decline internationally at the end of the last century. Our objective was to assess the current value of neonatal autopsy in providing additional information to families and healthcare professionals.
  
  
  METHODS
  We conducted a review of neonatal autopsies performed in a tertiary perinatal centre over an 11-year period. Primary outcomes measured were the annual neonatal autopsy rates and concordance rates between clinical and autopsy diagnoses of the primary cause of death. Secondary outcomes were the clinical, genetic and audit value of the examinations. Findings were used to inform the consent process, and the effect this had on institutional post-mortem rates was assessed over the subsequent 5-year period.
  
  
  RESULTS
  There was a marked decline in the annual neonatal autopsy rate from 73% in 1994 to 48% in 2004. 164 cases met the inclusion criteria for review. Complete concordance for cause of death was reached in 91% of cases. Previously unsuspected or unconfirmed clinical conditions, other than the primary cause of death, were uncovered at autopsy in 85 cases. Detailed information on inheritable conditions was obtained in 45 cases. Findings with perceived 'audit value' for clinical practice were identified in 29 cases. The dissemination of this information to staff and families contributed to the stabilisation of the consent rate in the following 5-year period.
  
  
  CONCLUSIONS
  Neonatal autopsy remains a valuable diagnostic tool as it provides critical clinical and audit information for healthcare professionals and families.
authors.affiliation: Rotunda Hospital, Dublin, Ireland. leahmariahickey@yahoo.co.uk
authors.forename: Leah
authors.initials: L
authors.lastname: Hickey
authors.forename: Amanda
authors.initials: A
authors.lastname: Murphy
authors.forename: Deirdre
authors.initials: D
authors.lastname: Devaney
authors.forename: John
authors.initials: J
authors.lastname: Gillan
authors.forename: Tom
authors.initials: T
authors.lastname: Clarke
mesh_terms: D001344:Autopsy / Q000706:statistics & numerical data* / Q000639:trends; D002423:Cause of Death; D003951:Diagnostic Errors; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000175:diagnosis* / Q000453:epidemiology; D007494:Ireland / Q000453:epidemiology; D008485:Medical Audit; D015203:Reproducibility of Results; D012189:Retrospective Studies