Abstract
Objectives To describe the trend and factors associated with the autopsy over the past decade
at a level III neonatal intensive care unit (NICU) where all patients are presented
with an option.
Study Design Retrospective study of the autopsy in a cohort of infants who died in the NICU from
January 1, 2001, to December 31, 2010.
Results Of 446 deaths, 33.9% received the autopsy and rates decreased from the 2 years prior
to the study. The autopsy was associated with gestational age at birth and chronologic
age at death. On multivariable logistic regression analyses, the odds of an autopsy
increased with gestational age (p = 0.001), death in the postneonatal period (odds ratio [OR] = 2.01, 95% confidence
interval [CI] = 1.28, 3.16), and absence of a major congenital anomaly (OR = 1.96,
95% CI = 1.22, 3.23).
Conclusion Autopsy rates continue to decline despite ensuring that all parents are presented
with the option. Infants born at term and those who die after 1 month without known
congenital anomalies are most likely to receive the autopsy. The persistently low
rates may highlight the importance of helping families understand that the autopsy
has utility even when the cause of death may appear to be obvious.
Keywords
autopsy rate - autopsy consent - neonatal death
