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Decreasing use of autopsy for stillbirths and infant deaths: missed opportunity

Abstract

Objective

We assessed whether the tendency towards decreasing use of fetal and infant autopsy was associated with a greater proportion of deaths in which the cause is never found.

Study Design

We computed autopsy rates over time for 13,466 stillbirths and 16,880 infant deaths in Quebec, Canada, 1981–2015. We assessed the proportion of deaths with an undetermined cause and determined the relationship with non-autopsy over time.

Result

Autopsy rates declined by 29% for stillbirths and 36% for infant deaths during the study. The proportion of non-autopsied cases with an undetermined cause of death increased only for stillbirths, however. Among non-autopsied stillbirths, the risk of having an undetermined cause of death was 1.64 times higher in 2005–2015 compared with 1981–1992 (95% confidence interval 1.25, 2.15).

Conclusion

Greater use of autopsy has potential to minimize the number of stillbirths with an undetermined cause of death, and may be helpful for prevention.

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Acknowledgements

The study was funded by the Canadian Institutes of Health Research (PJT-156062; APR-126340) and the Fonds de recherche du Québec-Santé (34695). We thank Dr. Dorothée Dal Soglio (pathologist, Sainte-Justine Hospital Research Centre) and Dr. Tuyet Nhung Ton Nu (pathologist, McGill University Hospital Research Centre) for helpful contributions to the manuscript.

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Correspondence to Nathalie Auger.

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Auger, N., Bilodeau-Bertrand, M., Poissant, J. et al. Decreasing use of autopsy for stillbirths and infant deaths: missed opportunity. J Perinatol 38, 1414–1419 (2018). https://doi.org/10.1038/s41372-018-0191-y

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