Pathology of the central autonomic nervous system in stillbirth

The aim of this study was to identify in stillbirth a possible involvement of morphological and/or physiological alterations of structures of the central autonomic nervous system in the mechanism of death. The study, including the in-depth histological examination of brainstem and cerebellum, was performed on 42 stillbirths, aged from 22 to 40 gestational weeks, 12 of which were explained and 30 were unexplained deaths. In the sudden unexplained stillbirths a variety of morphological and/or biological abnormalities of different structures and nuclei was found, above all the hypoplasia of the parafacial complex, frequently associated with hypoplasia of the arucate and pre-Bötzinger nuclei, and with thyrosine-hydroxilase immunonegativity in the locus coeruleus. A significant correlation was also observed between the neuropathologic findings and mother’s smoking habit.