Clinical importance of neonatal autopsies

Ankara University School of Medicine, Department of Pediatrics Ankara University School of Medicine, Department of Pediatrics, Division of Neonatology Ankara University School of Medicine, Department of Pathology Aim: To asses the neonatal autopsy rate at a tertiary referral center and to investigate any discordance between the diagnosis before death and at autopsy. Materials and Methods: This retrospective study was performed at neonatal intensive care unit (NICU) of Ankara University Hospital between January 1997 and June 2003. Written parental consent was obtained prior to autopsy. Each examination was performed by a pathologist using standard techniques including bacterial cultures, macroscopic and histological examination, postmortem radiography and chromosomal analysis if necessary. Clinico-pathologic concordance was divided into four categories: (1) change in diagnosis, (2) additional findings, (3) complete confirmation and (4) inconclusive. Results: In this period 87/1876 (4.6%) neonates died and autopsy was performed in 34/87 (39%) of the cases. The studied population had a median gestational age, birth weight and a median age of 35 weeks, 1990 g. and 5 days respectively. After autopsy, diagnosis changed in 4/34 (11.7%), additional findings were found in 4/34 (11.7%), diagnosis was confirmed in 25/34 (73.5%) and diagnosis was inconclusive in 1/34 (2.9%). Conclusion: Neonatal autopsies can be suggested when the cause of death is not evident or additional information is needed. Important information can be obtained from neonatal autopsies. Clinicians can confidently advise parents of the usefulness of the neonatal autopsy in ascertaining the cause of death or for counseling their future pregnancy.