The author studied the deaths of newborn infants during a 9-year-period between 1958 and 1966. The autopsied cases totalled 126 which comprised of 24 stillborn babies and 102 newborn infants.
This survey consisted primarily in the pathological examination of principal lesions, and inquiries were made into body weight at birth, gestation period and survival period of each case; the results from the former and the latter were compared with a view of finding some relationship between them. Morphological survey was further carried out to see how the growth of organs was correlated with the existence of extramedullary hematopoietic foci.
1) As regards the principal patho-anatomical changes, the disturbance of respiratory system, in which atelectasis played a main role, was observed in 52.3 % of the entire cases; severe malformation (12.0 %) and circulatory disturbance of the central nervous system (9.6 %) ranked next; infections were observed in 14.3 %, the majority of which consisted of pneumonia, particularyl bronchopneumonia.
2) Tendency of hypoplasia of all organs and that of atelectasis were conspicuous in lowweight infants.
3) The less the number of weeks in gestation period was, the higher the incidence of atelectasis.
Malformation and infection were frequently seen among the full term infants (40-weeks-gestation) .
4) Regarding the cases of death in relation to the survival period, the majority of stillborn infants were those of malformation and maceration, and 40.2 % of the infants died of atelectatasis or hypoplasia within 24 hours of birth. Infection became more frequently the cause of death as the survival period became longer.
5) In the observation of the development of each organ, survey was carried out on the lung, liver and kidney of each case. The lung developed the latest, having reached maturation in only 52.3 % of the entire cases.
6) To measure the organ development in terms of body-weight at birth, the border-line between hypoplasia and maturation could be drawn at 2, 000 gm. or 36-37 weeks in gestation period. Viewed in the light of survival period, hypoplasia was highly correlated with the incidence of death at the stage of 1-24 hours after birth.
7) Extramedulary hematopoietic foci were investigated in liver and spleen. They remained in livers of 90 % of the cases, and in spleens of 50 %.
8) The lower the body-weight at birth was, the more marked the remaining of extramedullary hematopoietic foci. When the body weight exceeded 2, 500 gm. the number of these foci markedly decreased. The remaining of the foci became also more marked as the number of weeks in gestation period became less. In view of surival period, the remaining of the foci was marked in infants who died within 24 hours of birth.
9) The study concerning atelectasis and malformation shows that the principal pathoanatomical changes are closely correlated with hypoplasia and the remaining of extramedullary hematopoietic foci, even if the organs had matured, if the fetus had some latent factors which would cause anoxia at the time of birth.
10) From the results mentioned above, the present author maintains that, in a pathologic sense, the death of newborn infant is correlated most closely with the condition of development of each organ.
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