Newborn Autopsies: Experience of Referral Level III Neonatal Intensive Care Unit in Turkey

Abstract

Objective: Neonatal autopsies are a guide to explore the causes of the perinatal mortalities which is important marker for evaluation of the health policies. Multidisciplinary approach which includes obstetrician, pediatrician, pathologist and geneticist is required for the neonatal autopsies. In our study, we have examined the significance of neonatal autopsy in neonatal deaths occurred in our clinic within 2 years, and analyzed whether neonatal autopsy has any impact on confirming and/or modifying reason of death. Methods: Thirty-eight neonatal autopsies between January 2009 and December 2010 were evaluated in respect to demographic characteristics, clinical and pathological diagnosis retrospectively. Results: Totally 7055 neonates were hospitalized in our neonatal intensive care unit between January 2009 and December 2010. Among them, 404 of the neonates passed away (5.7%). Only 38 (9.4%) of the neonates' parents gave permission for autopsy. Fifteen of these neonates were female (39%) and 23 of them were male (61%). Sixty percent of these neonates were premature. Prematurity was higher in male neonates (p=0.001). Median week of gestation was 32 (22-41). Median overall survival of the neonates were 4 (0-80) days. When compared according to gender, there was statistically no significant difference between survival periods. Prematurity rate was quite high among male neonates (p=0.001). Eighty-three percent of the clinical diagnoses were correlated with the pathological diagnosis. Sixty percent of the clinical and pathological diagnoses were cardiovascular anomalies, diaphragmatic hernia, perinatal asphyxia and prematurity. Two neonates had pneumonia diagnosis by the autopsy. Only one of these cases had chorioamnionitis in the placenta. Conclusion: Neonatal autopsy rates should be increased to decrease the neonatal mortality rate in our country. Neonatal autopsies should be done with multidisciplinary approach and become prevalent and get more progress in our country.