Follicular ovarian cysts in stillbirths and neonates

A review of the histology of 332 ovaries from stillbirths and neonatal deaths within the first 28 days of life showed that follicular cysts, lined by granulosa epithelium and having a diameter greater than 1 mm on a microscopical section, were present in 113 infants. In 48 cases multiple cysts were present, while in 65 only a single cyst satisfying the criteria was found. There was an excess number of infants of low birthweight score among those with multiple cysts and the results were highly significant. Cysts, whether single or multiple in distribution, were commoner with increasing gestation, and possibly occurred more commonly in the infants of diabetic mothers and in infants where pregnancy had been complicated by rhesus isoimmunization. The nature of the changes seen in the granulosa lining and theca internal layer surrounding the cysts suggested that these cysts were not some degenerative phenomenon but occured in response to stimulation. It is suggested that homologous changes may occur in the testis of the dysmature male. The possible significance of these findings with regard to hormonal imbalance in the growth-retarded infant is considered, and the need for closer attention to endocrine function in these infants stressed.