Abstract
Introduction: Ending preventable perinatal deaths have become a priority in global public health agenda, highlighting the importance of collecting quality data related to perinatal mortality. Pathological post-mortems and placental examination play a vital role in identifying the cause of death. The objective of this analysis was to classify causes of death according to a uniform classification system, enabling comparison of data in different settings. Congenital malformations were further categorized according to the involved organ system. Method: This is a retrospective analysis of post-mortems of stillbirths (including the placentas) and neonatal deaths already reported at the Department of Pathology, University of Colombo from 2009-2015. Autopsy and placental examination were performed according to standard protocols. The cause of death was classified according to ICD-PM. Results: The study included 291 post - mortems; 198 stillbirths, 7 intra-partum deaths and 86 neonatal deaths. Ante-partum hypoxia was the commonest cause of death in stillbirths (83/198=41.9%), while, congenital malformations was the commonest in intra-partum (5/7=71.4%) and neonatal deaths (38/86=44.2%). Low birth weight and prematurity is the second most common cause in neonatal deaths (24/86=27.9%). Malformations were commonly present in cardiovascular system (stillbirths: 22/47=47%, intra-partum and neonatal deaths: 31/62=50%) followed by respiratory system (stillbirths: 14/47=30%, intra-partum and neonatal deaths: 20/62=32%). Conclusion: Ante-partum hypoxia, congenital malformations and low birth weight and prematurity are the leading causes of death in stillbirths and neonates however, quality data of a prospective study, analyzing maternal and feto/infant pathology together, is required to improve the validity of the results.
Highlights
Ending preventable perinatal deaths have become a priority in global public health agenda, highlighting the importance of collecting quality data related to perinatal mortality
This is a retrospective analysis of post-mortems of stillbirths and neonatal deaths already reported at the Department of Pathology, University of Colombo from 2009-2015
Ante-partum hypoxia was the commonest cause of death in stillbirths (83/198=41.9%), while, congenital malformations was the commonest in intra-partum (5/7=71.4%) and neonatal deaths (38/86=44.2%)
Summary
Ending preventable perinatal deaths have become a priority in global public health agenda, highlighting the importance of collecting quality data related to perinatal mortality. Pathological post-mortems and placental examination play a vital role in identifying the cause of death. The objective of this analysis was to classify causes of death according to a uniform classification system, enabling comparison of data in different settings. Congenital malformations were further categorized according to the involved organ system. Despite a decline in childhood mortality in last few decades, there is no significant aSenior Lecturer, Department of Pathology, Faculty of Medicine, University of Colombo bResearch Assistant, Department of Pathology, Faculty of Medicine, University of Colombo cProfessor of Pathology, Department of Pathology, Faculty of Medicine, University of Colombo.
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