Section of Neonatal-Perinatal Medicine, Children's Mercy Hospitals and Clinics, Kansas City, Missouri.
Am J Perinatol. 2013 Oct;30(9):739-44. doi: 10.1055/s-0032-1332798. Epub 2013 Jan 15.
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.
Retrospective study of the autopsy in a cohort of infants who died in the NICU from January 1, 2001, to December 31, 2010.
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).
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.
描述过去十年间三级新生儿重症监护病房（NICU）中所有患者都有选择进行尸检的情况下，尸检的趋势和相关因素。
对 2001 年 1 月 1 日至 2010 年 12 月 31 日期间在 NICU 死亡的婴儿队列进行回顾性研究。
446 例死亡病例中，33.9%接受了尸检，且尸检率从研究前 2 年开始下降。尸检与出生时的胎龄和死亡时的年龄有关。多变量逻辑回归分析显示，随着胎龄（p=0.001）、新生儿后期死亡（比值比[OR]=2.01，95%置信区间[CI]：1.28，3.16）和无重大先天性异常（OR=1.96，95%CI：1.22，3.23），尸检的可能性增加。
尽管确保所有家长都有选择进行尸检的机会，但尸检率仍持续下降。足月出生和 1 个月后死亡且无明显先天性异常的婴儿最有可能接受尸检。持续低比率可能突出表明，即使死因似乎显而易见，尸检也具有实用性，因此需要帮助家属理解这一点。
