A new study validates the use of minimally invasive autopsies (MIAs) to accurately determine the cause of death in stillbirths and neonatal deaths. Since MIAs are less invasive, simpler, and more feasible, they could be an excellent tool to guide the development of preventative strategies to improve child survival in low-income, high-burden communities.
Each year, over 5 million babies are stillborn or die within their first month. When healthcare workers know the cause of death, they are better able to design effective interventions; however, performing complete diagnostic autopsies is not the norm in low-income, high-burden communities since they are invasive, costly, and often not feasible. Rather, because 99% of stillbirths and neonatal deaths occur in low- and middle-income countries, verbal autopsies are most typical. Not only are verbal autopsies subject to a high degree of misclassification errors and/or poor specificity, vital registration systems in these communities are often nonexistent, inadequate, or not medically certified.The result is that healthcare workers lack adequate information to guide the design of prevention strategies.
A research team from Spain developed a simplified, minimally invasive autopsy (MIA) and investigated whether it was as effective at determining the cause of death in stillbirths and neonatal deaths as was a complete diagnostic autopsy. They assessed the cause of death in 18 stillbirths and 41 neonates who died in Mozambique using both autopsy methods.The MIA revealed the cause of death in 83% of the stillborn babies and 89% of the neonatal deaths. Moreover, there was substantial agreement (>75%) between the results of both the MIA and the complete diagnostic autopsy. The concordance was particularly high in cases where the cause of death was an infectious disease.
This study indicates that MIAs could be an accurate, feasible, and effective tool for determining the cause of death in stillborn and neonatal babies, providing healthcare workers in low-income, high-burden areas with relevant data to guide the development of effective intervention strategies.
Written by Debra A. Kellen, PhD
Citation: Menendez, C., Castillo, P., Martínez, M. J., Jordao, D., Lovane, L., Ismail, M. R., … & Hurtado, J. C. (2017). Validity of a minimally invasive autopsy for cause of death determination in stillborn babies and neonates in Mozambique: An observational study. PLoS medicine, 14(6), e1002318.
Published: June 20, 2017 https://doi.org/10.1371/journal.pmed.1002318