[A neuropathological analysis of neonatal deaths over a 20-year period]

This study is an overview of 2,515 consecutive autopsies on newborn infants who died during the first 28 days of life at the Hospital for Sick Children, Toronto, during the period 1970-1989. The infants were grouped into 2 categories according to their gestational age and then subdivided into the groups of early (0-6 days) and late (7-28 days) neonatal deaths. In this overview trends in the occurrence of neuropathological observation were documented. In each 5-year time period and each gestational group the following diagnoses were recorded; hypoxic-ischemic neuronal changes, periventricular leukomalacia, infarction, kernicterus, meningitis, and hemorrhage (subependymal, parenchymal, choroidal). In these 20 years, the mortality in preterm infants has decreased due to a fall in the incidence of subependymal/intraventricular hemorrhage, kernicterus and meningitis. In contrast, the rate of mortality in term infants has increased due to a higher frequency of hypoxic-ischemic neuronal necrosis and choroid plexus hemorrhage.