Inter-center variation in autopsy practices among regional neonatal intensive care units (NICUs)

ICON - CHNC Executive Committee

Objective: To characterize infants who underwent autopsy in regional neonatal intensive care units (NICUs) and examine inter-center variability in autopsy completion.

Study design: Retrospective cohort study of infants who died between 2010 and 2016 from 32 participating hospitals in the Children’s Hospital Neonatal Database (CHND). Maternal/infant demographics and hospital stay data were collected, along with autopsy rates by center, year, and region. Data analysis utilized bivariate and multivariable statistics.

Result: Of 6299 deaths, 1742 (27.7%) completed autopsy. Infants who underwent autopsy had higher median birth weight (2 124 g vs. 1 655 g) and gestational age (34 vs. 32 weeks). No differences were seen in sex, length of stay, or primary cause of death. Marked inter-center variability was observed, with 17-fold adjusted difference (p < 0.001) in autopsy rates.

Conclusion: Patient characteristics do not account for variability in autopsy practices across regional NICUs. Factors such as provider practices and parental preferences should be investigated.

Datta A, Niehaus JZ, Weiner J, Zaniletti I, Matoba N, Sullivan KM, DiGeronimo R, Coghill CH, Natarajan G, Leuthner SR, Schlegel AB, Shah A, Murthy K; Children’s Hospital Neonatal Consortium (CHNC), Fry JT.J Perinatol. 2021 Dec;41(12):2820-2825. doi: 10.1038/s41372-021-01286-1. Epub 2022 Jan 4.PMID: 34983934

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