Differences in Postmortem Investigation following Perinatal Death

Abstract

Objective The study aimed to describe the postmortem investigation patterns for perinatal deaths and compare the degree of investigation between stillbirths and early neonatal deaths.

Study Design We conducted a single-center retrospective review of all perinatal deaths from 2011 to 2017. Perinatal death was defined as intrauterine fetal death at ≥20 weeks' gestation, plus neonatal deaths within the first 7 days of life. Rates of postmortem investigation were compared.

Results There were 97 perinatal deaths, with 54 stillbirths (56%) and 43 neonatal deaths (44%). Stillbirths were significantly more likely to receive autopsy (p = 0.013) and postmortem genetic testing (p = 0.0004) when compared with neonatal deaths. Maternal testing was also more likely in stillbirths than neonatal deaths. A total of 32 deaths (33%) had no postmortem evaluation beyond placental pathology.

Conclusion Investigation following perinatal death is more likely in stillbirths than neonatal deaths. Methods to improve postmortem investigation following perinatal death are needed, particularly for neonatal deaths.

Key Points

• Investigation into perinatal death is recommended.

• Rates of investigation remain low.

• Neonatal deaths with less investigation than stillbirths.

Keywords

perinatal death - autopsy - stillbirth

Authors' Contributions

M.A.N. conceptualized study, collected data, and drafted the initial manuscript. K.B. and R.B. helped formulate the methods, reviewed the data, supervised data collection, and interpreted the results. J.A. provided statistical expertise and data review. G.H.R. reviewed the protocol and assisted with data collection. All authors edited the manuscript and approved the final manuscript as submitted. All authors agree to be accountable for all aspects of the work.

Note

The appropriate institutional review board approved this study. This study was performed in accordance with the Declaration of Helsinki.

Publikationsverlauf

Eingereicht: 01. Dezember 2020

Angenommen: 10. Mai 2021

Artikel online veröffentlicht:
14. Juni 2021

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