PATHOMORPHOLOGICAL FEATURES OF THE ADRENAL GLANDS OF INFANTS WHO DIED OF ASPHYXIA

Аннотация

Perinatal asphyxia remains a leading cause of neonatal mortality and morbidity worldwide, with complex pathophysiological mechanisms affecting multiple organ systems. To investigate the specific pathomorphological changes in adrenal glands of infants who died from perinatal asphyxia and correlate these findings with clinical parameters and duration of hypoxic exposure. A retrospective autopsy study was conducted on 156 infants who died from perinatal asphyxia over a 5-year period (2019-2024). Detailed histopathological examination of adrenal glands was performed using standard H&E staining, immunohistochemistry, and electron microscopy. Control group consisted of 78 infants who died from non-asphyxial causes. Significant pathomorphological changes were observed in 89.7% (140/156) of asphyxiated infants compared to 12.8% (10/78) in controls (p<0.001). Primary findings included cortical hemorrhage (67.3%), zona fasciculata lipid depletion (78.2%), medullary chromaffin cell necrosis (45.5%), and capsular thickening (56.4%). Severity of changes correlated positively with duration of asphyxia (r=0.742, p<0.001) and inversely with Apgar scores (r=-0.689, p<0.001). These findings contribute to understanding the pathophysiology of asphyxial death and may have implications for forensic diagnosis and therapeutic interventions.