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• We undertook a cross-sectional epidemiologic study of potential determinants of parental consent for neonatal autopsy at the Brigham and Women's Hospital, Boston. Data were abstracted from maternal and infant medical records in 184 cases of neonatal death occurring between January 1982 and October 1984. The o+verall consent rate for neonatal autopsy was 72%. Multivariate analysis by logistic regression found previous fetal loss, gestational age, and cause of death to be significantly different between the groups of consenters and nonconsenters. Parents least likely to consent to autopsy were those who had no history of previous fetal loss, who had pregnancies in which the birth weight of the infant was less than 1000 g or the gestational age was less than 28 weeks, or those who had an infant die of extreme prematurity. Factors not significantly associated with consent were maternal age, race, marital status, transfer status, type of prenatal care, the infant's sex, and the staff position of the requester. A second phase of the study surveyed physicians' attitudes regarding the importance of neonatal autopsy. The staff position and previous experience of the physician-requester, in addition to the presumed cause of the infant's death, were significantly associated with the rating assigned to the importance of the autopsy. These findings suggest that the mother's past and present obstetrical experience, the presence of extreme prematurity, and possibly the attitude and experience of the physician requesting autopsy permission may exert important influences on the likelihood of obtaining consent for a neonatal autopsy.(AJDC 1987;141:149-153)

This article discusses the photographs in the book "Life in Cold Blood" by David Attenborough. Photographs of amphibians and reptiles including the Australian Gastric Brooding Frog, the Indian Gharial, and the South African Armadillo are presented. The organization of the photographs to illustrate the evolutionary development of amphibians and reptiles is described.

A retrospective study of autopsy consent was undertaken to assess the autopsy rate for neonatal deaths and to identify demographic factors that were determinants of permission for autopsy. Of 127 neonatal deaths at the Brigham & Women's Hospital (1/82-9/83), 112 charts were available for review and 84 (75%) had autopsies. Factors which differed between the group which consented to autopsy and that which did not, were:Factors close to statistical significance included: maternal marital status, race, type of prenatal care, and the infant's age at death. Factors which were not correlated with permission were: maternal age, language, gravidarity, parity, occupation, transfer status, and infant gender. Thus, those at high risk for declining permission might include: parents of extremely premature infants or of infants with very brief nursery stays, and mothers who are clinic patients, unmarried, or Black. Reasons for failure to obtain autopsy permission may be related to demographic factors noted, the attitude of the physician towards the value of the autopsy in those situations, or both.*Mann Whitney test** Chi square test