Abstract
Autopsies of neonatal deaths are important because they help establish the cause of death, aid in counseling parents, and monitor diagnostic and therapeutic modalities in neonatal care. To determine clinical factors that may influence the decision to perform an autopsy, a retrospective chart review of 117 consecutive neonatal deaths in a tertiary care nursery was conducted. The overall autopsy rate of the neonatal deaths (78.6%) was significantly greater than the autopsy rate of adult deaths (36.8%) and non-neonatal pediatric deaths (66.3%) occurring in the same 24 month period at this institution. The percentage of neonatal deaths that was not autopsied was significantly greater among transported patients (30.9%)than among inborn patients (12.9%). Patients with birth weight <1000g, gestational age <28 weeks and those that died within 2 days of admission to the nursery were autopsied significantly less frequently if the patient was transported rather than inborn. Patients that died with major congenital anomalies had a significantly higher autopsy rate (91.2%) than those that died with other pre-mortum diagnoses, including RDS, perinatal asphyxia, or infections. Factors that did not influence the autopsy rate included sex, maternal age, race or marital status. Among inborn patients, birth weight and gestational age also did not affect the autopsy rate. These data suggest that the early separation of a mother from her sick newborn and the medical care team necessitated by infant transport adversely affects the process of autopsy request and consent.
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