Less invasive autopsy can identify cause of death in stillborn infants, newborns and children

Less invasive autopsy can identify cause of death in stillborn infants, newborns and children

According to global mortality estimates, more than 11 million deaths, including stillbirths, occur in low- and middle-income countries annually. But determining global mortality estimates and outlining subsequent global health targets requires precise and accurate reporting about cause of death.

While complete diagnostic autopsies (CDAs) are considered the gold standard for determining cause of death, they are challenging to perform in low-resource settings, indicating the need for a simpler and more feasible autopsy method with comparable precision to CDA.

Newborn health researcher Clara Menéndez and colleagues recently developed a minimally invasive autopsy (MIA) method, which was compared with CDA in two separate studies conducted in Mozambique.

In the first study, the researchers assessed the validity of a MIA in determining cause of death in 18 stillbirth cases and 41 newborn deaths in Mozambique. A cause of death was identified using CDA in 16 out of 18 (89 percent) of stillbirths and in all of the newborn deaths. Statistical analysis shows that MIA was in substantial agreement with CDA in categorizing disease when determining cause of death among the stillborn infants, and moderately in agreement with CDA in categorizing disease when determining cause of death among newborns.

In the second study, the researchers compared findings from MIA and CDA in 54 pediatric deaths in children less than 15 years of age. A cause of death was identified in all 54 cases using CDA and in 52 cases (96 percent) using MIA. Statistical analysis shows that MIA results agreed substantially with those of CDA in categorizing disease when determining cause of pediatric deaths.

The results of these studies show that MIA is in concordance with the more complicated gold standard method, the CDA, in determining cause of death among stillborn infants, newborns, and children. A more feasible autopsy method will likely lead to more reliable mortality estimates, helping policymakers and researchers develop preventative strategies and implementation priorities to avert stillbirth and prevent newborn and child death.

References

Bassat Q, Castillo P, Martínez MJ, Jordao D, Lovane L, Hurtado JC, et al. (2017) Validity of a minimally invasive autopsy tool for cause of death determination in pediatric deaths in Mozambique: An observational study. PLoS Med 14(6): e1002317. https://doi.org/10.1371/journal.pmed.1002317

Menéndez C, Castillo P, Martínez MJ, Jordao D, Lovane L, Ismail MR, et al. (2017) Validity of a minimally invasive autopsy for cause-of-death determination in stillborn babies and neonates in Mozambique: An observational study. PLoS Med 14(6): e1002318. https://doi.org/10.1371/journal.pmed.1002318

Image Credit: ISGlobal

Author

Sara Kassabian is the communications associate at PLOS, where she manages social media and edits the ECR Community Blog. Sara completed her MS in Global Health at the University of California San Francisco (UCSF), where her research focused on the prioritization of maternal and newborn health in global health policy. She can be reached by email at skassabian@plos.org and on Twitter @sarakassabian.

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