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Title: Epidemiological and pathological correlates of early neonatal mortality
Author: Becher, Julie-Clare
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 2006
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Objectives: An aim of this project was to identify clinical and genetic risk factors for early neonatal mortality within the Scottish population with special consideration to those infants born in an asphyxiated condition. A further aim was to determine the prevalence of antenatal brain injury within this population and to correlate neuropathology with clinical factors. Methods: Clinical data and neuropathological specimens were collected as part of the Scottish National Perinatal Neuropathology Study from all 22 delivery units throughout Scotland. Birth asphyxia was defined and infants were classified accordingly. Neuropathological examination was performed by a single observer in Edinburgh blind to clinical detail. Apolipoprotein E genotype was analysed and compared with known published data for adults and healthy newborns. Comparisons of categorical data were made with the Chi-square test and numerical data were compared using the unpaired student’s t-test and Mann Whitney U test. Results: Clinical data was collected from 191 early neonatal deaths. Complications of pregnancy were common in all neonatal deaths. The only predictive factors for asphyxia were indicators of intrapartum fetal distress. Neuropathological examination was possible in 59 infants surviving 3 days or less. Evidence of prelabour brain injury was observed in nearly half of this cohort, and this was significantly more common in asphyxiated infants and those who developed an encephalopathy. The only clinical associations of such damage were the presence of cardiotocograph abnormalities, meconium staining and severe depression at birth. Apolipoprotein E analysis was performed in 252 perinatal deaths. There was an over representation of the ε4 allele among healthy newborns compared to perinatal deaths and adults.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available