Minimally invasive autopsy can identify causes of Mozambique newborn and childhood deaths

Minimally invasive autopsy (MIA) can identify cause of death in pediatric, perinatal and neonatal deaths in Mozambique with significant precision and accuracy compared with complete diagnostic autopsy (CDA), according to two studies published by Clara Menéndez, Quique Bassat and colleagues from ISGlobal, Barcelona, Spain, in PLOS Medicine.

In the first study, the researchers compared cause of death determination from MIA and CDA in 18 stillbirths and 41 neonatal deaths. A cause of death was identified in 16/18 (89%) and 15/18 (83%) of stillborn babies and in all (100%) and 35/41 (85%) neonatal deaths in the CDA and the MIA, respectively. Causes of death identified for stillborn babies included fetal growth restriction (39%), infectious diseases (22%), intrapartum hypoxia (17%), and intrauterine hypoxia (11%), with the MIA showing substantial agreement with the CDA for categorization of disease (Kappa = 0.78, 95% CI [0.56-0.99]). For neonates, the majority of deaths were due to infectious diseases (66%) and the overall agreement of the MIA with the CDA for categorization of disease was moderate (Kappa = 0.40, 95% CI [0.18-0.63]).

In the second study, the researchers compared findings from MIA and CDA for 54 deaths in children <15 years of age. A cause of death was identified in all cases in the CDA and in 52/54 (96%) of the cases in the MIA, with infections (78%) and malignant tumors (13%) accounting for the majority of diagnoses. The MIA categorization of disease showed a substantial agreement with the CDA categorization (Kappa = 0.70, 95% CI 0.49-0.92).

The authors say: "Reliable estimates of the causes of stillbirths and neonatal and child mortality can help policy makers design and implement better and more evidence-based preventive strategies to improve child survival in high-burden low-income settings."

These two studies are part of an ongoing series of articles examining the validity of MIA in different populations. More articles about MIA can be found on the PLOS Minimally Invasive Autopsy collection page.