The value of autopsy in preterm infants at a Swedish tertiary neonatal intensive care unit 2002–2018

Abstract Reliable data on causes of death (COD) in preterm infants are needed to assess perinatal care and current clinical guidelines. In this retrospective observational analysis of all deceased preterm infants born < 37 weeks’ gestational age (n = 278) at a Swedish tertiary neonatal intensive...

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Autores principales:	Alice Hoffsten, Laszlo Markasz, Katharina Ericson, Leif D. Nelin, Richard Sindelar
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/1f71aa68d7234da386c6a2cbfa00661d
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spelling	oai:doaj.org-article:1f71aa68d7234da386c6a2cbfa00661d2021-12-02T18:33:57ZThe value of autopsy in preterm infants at a Swedish tertiary neonatal intensive care unit 2002–201810.1038/s41598-021-93358-72045-2322https://doaj.org/article/1f71aa68d7234da386c6a2cbfa00661d2021-07-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-93358-7https://doaj.org/toc/2045-2322Abstract Reliable data on causes of death (COD) in preterm infants are needed to assess perinatal care and current clinical guidelines. In this retrospective observational analysis of all deceased preterm infants born < 37 weeks’ gestational age (n = 278) at a Swedish tertiary neonatal intensive care unit, we compared preliminary COD from Medical Death Certificates with autopsy defined COD (2002–2018), and assessed changes in COD between two periods (period 1:2002–2009 vs. period 2:2011–2018; 2010 excluded due to centralized care and seasonal variation in COD). Autopsy was performed in 73% of all cases and was more than twice as high compared to national infant autopsy rates (33%). Autopsy revised or confirmed a suspected preliminary COD in 34.9% of the cases (23.6% and 11.3%, respectively). Necrotizing enterocolitis (NEC) as COD increased between Period 1 and 2 (5% vs. 26%). The autopsy rate did not change between the two study periods (75% vs. 71%). We conclude that autopsy determined the final COD in a third of cases, while the incidence of NEC as COD increased markedly during the study period. Since there is a high risk to determine COD incorrectly based on clinical findings in preterm infants, autopsy remains a valuable method to obtain reliable COD.Alice HoffstenLaszlo MarkaszKatharina EricsonLeif D. NelinRichard SindelarNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Alice Hoffsten Laszlo Markasz Katharina Ericson Leif D. Nelin Richard Sindelar The value of autopsy in preterm infants at a Swedish tertiary neonatal intensive care unit 2002–2018
description	Abstract Reliable data on causes of death (COD) in preterm infants are needed to assess perinatal care and current clinical guidelines. In this retrospective observational analysis of all deceased preterm infants born < 37 weeks’ gestational age (n = 278) at a Swedish tertiary neonatal intensive care unit, we compared preliminary COD from Medical Death Certificates with autopsy defined COD (2002–2018), and assessed changes in COD between two periods (period 1:2002–2009 vs. period 2:2011–2018; 2010 excluded due to centralized care and seasonal variation in COD). Autopsy was performed in 73% of all cases and was more than twice as high compared to national infant autopsy rates (33%). Autopsy revised or confirmed a suspected preliminary COD in 34.9% of the cases (23.6% and 11.3%, respectively). Necrotizing enterocolitis (NEC) as COD increased between Period 1 and 2 (5% vs. 26%). The autopsy rate did not change between the two study periods (75% vs. 71%). We conclude that autopsy determined the final COD in a third of cases, while the incidence of NEC as COD increased markedly during the study period. Since there is a high risk to determine COD incorrectly based on clinical findings in preterm infants, autopsy remains a valuable method to obtain reliable COD.
format	article
author	Alice Hoffsten Laszlo Markasz Katharina Ericson Leif D. Nelin Richard Sindelar
author_facet	Alice Hoffsten Laszlo Markasz Katharina Ericson Leif D. Nelin Richard Sindelar
author_sort	Alice Hoffsten
title	The value of autopsy in preterm infants at a Swedish tertiary neonatal intensive care unit 2002–2018
title_short	The value of autopsy in preterm infants at a Swedish tertiary neonatal intensive care unit 2002–2018
title_full	The value of autopsy in preterm infants at a Swedish tertiary neonatal intensive care unit 2002–2018
title_fullStr	The value of autopsy in preterm infants at a Swedish tertiary neonatal intensive care unit 2002–2018
title_full_unstemmed	The value of autopsy in preterm infants at a Swedish tertiary neonatal intensive care unit 2002–2018
title_sort	value of autopsy in preterm infants at a swedish tertiary neonatal intensive care unit 2002–2018
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/1f71aa68d7234da386c6a2cbfa00661d
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The value of autopsy in preterm infants at a Swedish tertiary neonatal intensive care unit 2002–2018

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