To measure the neonatal autopsy rate at a tertiary referral centre and identify trends over the past decade. To identify factors that may influence the likelihood of consent being given for autopsy. To examine any discordance between diagnoses before death and at autopsy.
Retrospective review of patients' records.
Tertiary neonatal referral centre affiliated to university.
Sex, gestational age, birth weight, type of delivery, and length of stay in neonatal unit for baby. Maternal age, marital status, history of previous pregnancies, and details of who requested permission for autopsy. Concordance between diagnoses before death and at autopsy.
An autopsy was performed in 209/314 (67%) cases. New information was obtained in 50 (26%) autopsies. In six (3%) cases this information was crucial for future counselling. In 145 (74%) there was complete concordance between the clinical cause of death and the findings at autopsy. From 1994 onwards the autopsy rate in the neonatal unit fell. The only significant factor associated with consent for autopsy was increased gestational age.
Important extra information can be gained at neonatal autopsies. This should help parents to make an informed decision when they are asked to give permission for their baby to have an autopsy. These findings are of particular relevance in view of the recent negative publicity surrounding neonatal autopsies and the general decline in the neonatal autopsy rate over the decade studied.
What is already known on this topic
The neonatal autopsy rate dropped in Illinois during the 10 years from 1984 to 1993
Over recent years there has been a large amount of negative publicity surrounding neonatal autopsies in the United Kingdom
What this study adds
Over a quarter of neonatal autopsies yielded new information; in 3% of cases this information was crucial
This finding is likely to be of use to bereaved parents who are asked to give permission for autopsy and provides a more positive perspective on the utility of neonatal autopsies