The causes of early neonatal mortality at the present stage according to pathoanatomical autopsies data
Aim. To establish the causes and nosological profile of deaths in the early neonatal period. Materials and methods. A comprehensive analysis of 530 autopsies was made in the department of pathology of infancy and childhood of Chelyabinsk regional pathoanatomical bureau in the years 2006-2014. Results. A tendency towards increase in the number of dead infants at 22-27 weeks of gestation was recorded during the study period. Mothers in this group were more often of late reproductive and pre-reproductive age, unemployed, had burdened obstetrical history. The number of infant deaths from respiratory distress syndrome, post-anoxic encephalopathy, bronchopulmonary dysplasia, and iatrogenic disease increased the year 2012. Sudden infant death syndrome became the cause of death of more than half of infants that died in the home environment in the year 2014. An uncertain group diagnosis «intrauterine infection» in 22.5% of the dead infants was due to a lack of capacity to identify an infectious agent, and the percentage of this diagnosis is increasing annually. Infectious and inflammatory changes were subsequently identified in 83.3% of placental expulsion: rising infection predominated (41.1%) at labor at 22-27 weeks of gestation and hematogenous and combined infection (22-12.7%) with timely delivery. Conclusion. More than a half among the children that died at their first year of life are the premature children and the third are those who died in the early neonatal period. According to pathoanatomical autopsies the causes of death at newborns more often are respiratory distress-syndrome, prenatal infection and congenital development defects.