Nathalie Auger1,2, Marianne Bilodeau-Bertrand3,4, Julie Poissant4, Prakesh S Shah5,6. 1. University of Montreal Hospital Research Centre, 900 Saint-Denis, Montreal, QC, H2X 0A9, Canada. nathalie.auger@inspq.qc.ca. 2. Institut national de santé publique du Québec, 190 Cremazie E. Blvd, Montreal, QC, H2P 1E2, Canada. nathalie.auger@inspq.qc.ca. 3. University of Montreal Hospital Research Centre, 900 Saint-Denis, Montreal, QC, H2X 0A9, Canada. 4. Institut national de santé publique du Québec, 190 Cremazie E. Blvd, Montreal, QC, H2P 1E2, Canada. 5. Department of Pediatrics, University of Toronto, Mount Sinai Hospital, 600 University Avenue, Toronto, M5G 1X5, Canada. 6. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.
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.
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 infantdeaths 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 infantdeaths 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.
Authors: S C Shelmerdine; J C Hutchinson; L Ward; T Sekar; M T Ashworth; S Levine; N J Sebire; O J Arthurs Journal: Ultrasound Obstet Gynecol Date: 2020-05 Impact factor: 7.299