749 Neonatal Post-Mortem Rates: A 10 Year Experience at a Tertiary Centre in the Uk

Abstract

Background: Post-mortem examination is important in determining cause of death and can add addition information even when the cause is felt to be apparent. The organ retention scandal in 1999 has changed the perception of post-mortems particularly in children.Aims: To determine the post-mortem rates for babies who have died on our neonatal unit and to see if there are any differences between term and preterm babies.Methods: All babies who died on our neonatal unit from January 2000 to December 2009 were identified using a combination of our neonatal databases, admissions book and death certificates. Post-mortem examinations were determined from our neonatal database and mortuary records.Results: There were 329 deaths and 80 postmortems performed during this period (24%). The yearly post-mortem rate for all babies varies from 13 to 39 percent. Over the 10 year period, rates were 31 percent for term babies and 23 percent in preterm infants. Rates in extreme preterm infants were only 17 percent. There is a statistically significant difference between the post-mortem rates in term, 29-36 week gestation and extreme preterm infants.Conclusion: Our post-mortem rates are lower than expected and vary from year to year. The rates are particularly low in the extreme preterm infants. The reasons for this are likely to be complex but include parents feeling they already know why their baby has died and also because they feel they do not wish to put their preterm babies through further suffering.