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 gesta- tional 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 arcuate and pre-Botzinger nuclei, and with thyrosine-hydroxylase immunonegativity in the locus coeruleus. A significant correla- tion was also observed between the neuropathologic findings and mother's smoking habit.