Fetal, neonatal, and infant death in central China (Hubei): A 16-year retrospective study of forensic autopsy cases

An audit of foeticide, neonaticide and infanticide: A retrospective study in the Department of Forensic Medicine, King Edward Medical University, Lahore

The deliberate killing of a foetus in the womb, or a child from the first 24 h of birth to one month of age, or within the first year of life, is called foeticide, neonaticide and infanticide, respectively. Socioeconomic stress, mental illness, gender selection, shame or fear of punishment of adultery or illegitimacy, grudge and jealousy with parents and negligent delivery by dai are major causative factors in such cases. This is a retrospective, descriptive, observational study, and the sample pool consisted of 35 cases. Foeticide cases were 42.9% of the total and the same percentage of cases were neonaticides, while 14.3% of cases were of infanticide. The male-to-female ratio was 1.26:1 and the major cause of death was head injury. The study shows a prevalence of foeticide and neonaticide as compared to infanticide. It also displays the prevalence of males in overall cases and a higher number of unknown cases in our setting.

Medico-legal analysis of cases of children who died suddenly due to pneumonia undiagnosed in their lifetime

Pneumonia is one of the most common causes of children's hospitalization and death. The aim of the study was a medico-legal analysis of children who died suddenly due to pneumonia undiagnosed in their lifetime. The research was of a retrospective character and consisted in an analysis of prosecution files. The study included 47 children who died between 2011-2018 in whom pneumonia after post-mortem examination was indicated as the cause of death, as well as children in whom the cause of death, despite additional post-mortem examinations, including histopathological tests, was not established. In some cases, under additional post-mortem examinations, additional targeted immunohistochemical staining of selected lung sections was performed to establish the diagnosis. In children with prodromal symptoms, histopathological examination showed significantly more frequent atelectasis than in children without prodromal symptoms. Pneumonia is a significant clinical problem. Especially in young children, it may proceed with- out any symptoms that would cause such a diagnosis to be made. A properly conducted post-mortem diagnosis supplemented by immunohistochemical examinations allows to reduce the number of unexplained deaths in children.

Mortalidade neonatal específica por idade e fatores associados na coorte de nascidos vivos em 2021, no estado do Rio de Janeiro, Brasil

RESUMO Objetivo: Analisar a magnitude dos óbitos neonatais (ON), as causas de morte e os fatores associados por idade específica na coorte de nascidos vivos em 2021, no estado do Rio de Janeiro. Métodos: Coorte retrospectiva de nascidos vivos (NV) seguidos até 27 dias do parto (<24 horas, 1–6 e 7–27 dias). Dados obtidos dos Sistemas de Informações sobre Nascidos Vivos (2021) e Mortalidade (2021/2022). Foram descritas as distribuições das características maternas e do recém-nascido, causas de mortes e evitabilidade. Foram utilizados modelos de regressão multinomial com níveis hierárquicos de determinação do ON. Resultados: Dos 179.837 NV, morreram 274 até 24 horas, 447 de 1 a 6 dias e 324 de 7 a 27 dias. A taxa de mortalidade neonatal foi 5,8‰ NV (intervalo de confiança — IC95%: 5,5–6,2). Sobreviventes e ON foram heterogêneos segundo caraterísticas analisadas, exceto história reprodutiva (p<0,05). Das causas de morte, 78% eram evitáveis. Predominaram causas reduzíveis por adequada atenção à gestante (<24 horas e 1–6 dias) e ao recém-nascido (7–27 dias). No nível distal, baixa escolaridade mostrou associação significante para óbitos entre 7 e 27 dias (ORajustado=1,3), cor parda, para óbitos de 1–6 dias (ORajustado=1,3) e cor preta, para ambas as idades (1–6: ORajustado=1,5; 7–27 dias: ORajustado=1,8). Fatores assistenciais e biológicos do NV (níveis intermediário e proximal) mantiveram-se fortemente associadas aos ON, independentemente da idade. Conclusão: As causas de morte, os fatores associados ao ON e a força de associação diferiram conforme a idade do óbito. Ações preventivas do ON devem considerar vulnerabilidades sociodemográficas e intensificar uma assistência adequada pré-natal e perinatal.