Register for email alerts and news feeds:
This journal | BMJ Group
rss
Archives of Disease in Childhood - Fetal and Neonatal Edition 2004;89:F399-F407; doi:10.1136/adc.2003.037606
Copyright © 2004 BMJ Publishing Group Ltd & Royal College of Paediatrics and Child Health.
Archives of Disease in Childhood Fetal and Neonatal Edition 2004;89:F399-F407
© 2004 Archives of Disease in Childhood Fetal and Neonatal Edition

ORIGINAL ARTICLE

The Scottish perinatal neuropathology study: clinicopathological correlation in early neonatal deaths

J C Becher1, J E Bell2, J W Keeling3, N McIntosh1 and B Wyatt2

1 Department of Child Life and Health, University of Edinburgh, Edinburgh, Scotland, UK
2 Department of Pathology, University of Edinburgh
3 Department of Paediatric Pathology, Royal Hospital for Sick Children, Edinburgh

Correspondence to:
Correspondence to:
Professor McIntosh
Department of Child Life and Health, Reproductive and Developmental Medicine, 20 Sylvan Place, Edinburgh EH9 1UW, Scotland, UK; neil.mcintosh{at}ed.ac.uk

Background: A proportion of neonatal deaths from asphyxia have been shown to be associated with pre-existing brain injury.

Objectives: (a) To compare the epidemiology of infants displaying signs of birth asphyxia with those not showing signs; (b) to examine the neuropathology and determine if possible the timing of brain insult comparing asphyxiated with non-asphyxiated infants; (c) to compare the clinical features of those born with birth asphyxia with and without pre-labour damage.

Methods: Over a two year period, all 22 Scottish delivery units collected clinical details on early neonatal deaths. Requests for post mortem included separate requests for detailed neuropathological examination of the brain. Infants were classified into two groups: birth asphyxia and non-birth asphyxia. Clinicopathological correlation was used to attempt to define the time of brain insult.

Results: Detailed clinical data were available on 137 of 174 early neonatal deaths that met the inclusion criteria. Seventy of 88 parents who had agreed to post mortem examination consented to a detailed examination of additional samples from the brain; in 53 of these cases the infant was born in an asphyxiated condition. All asphyxiated and encephalopathic infants, 38% of mature and 52% of preterm infants with features of birth asphyxia but without encephalopathy, and only one of 12 infants without any signs of birth asphyxia showed damage consistent with onset before the start of labour.

Conclusions: In a large proportion of neonatal deaths, brain injury predates the onset of labour. This is more common in infants born in an asphyxiated condition.

Keywords: birth asphyxia; death; neuropathology; cohort study


Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?

Relevant Article

Fantoms
Ann Stark
Arch. Dis. Child. Fetal Neonatal Ed. 2004 89: F377. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

  • Groenendaal, F, Lammers, H, Smit, D, Nikkels, P G J (2006). Nitrotyrosine in brain tissue of neonates after perinatal asphyxia. Arch. Dis. Child. Fetal Neonatal Ed. 91: F429-F433 [Abstract] [Full Text]  
  • Bax, M., Tydeman, C., Flodmark, O. (2006). Clinical and MRI Correlates of Cerebral Palsy: The European Cerebral Palsy Study. JAMA 296: 1602-1608 [Abstract] [Full Text]  
  • Bell, J. E., Becher, J.-C., Wyatt, B., Keeling, J. W., McIntosh, N. (2005). Brain damage and axonal injury in a Scottish cohort of neonatal deaths. Brain 128: 1070-1081 [Abstract] [Full Text]  
  • (2004). Minerva. BMJ 329: 750-750 [Full Text]  

This Article

Services
Citing Articles
Google Scholar
PubMed
Topic Collections
Bookmark with

Register for free content

The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.

Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.

Latest from ADC

 

ADC is co-owned by the RCPCH and is the official journal of the European Academy of Paediatrics

BMJ Careers - Latest Paediatrics and Paediatric Surgery Jobs

Paediatrics and Paediatric Surgery Jobs