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The Pathology of Neonatal Pneumonia

Am J Dis Child. 1961;101(3):350-363. doi:10.1001/archpedi.1961.04020040078008.
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Perinatal infection, which has accounted for 10% to 20% of newborn deaths,1 remains in this era of almost universal antibiotic therapy a source of medical frustration. Continuing stress in the last 30 to 40 years has been placed on pneumonia, which, according to Claireaux,1 accounts for approximately 90% of fatal neonatal infection, and studies of congenital pneumonia in stillborn and liveborn infants have done much to clarify the relationship of bacterial infection to amniotic fluid aspiration in the pathogenesis of neonatal pneumonitis.2-5

In his early studies, Hess Thaysen6 classified neonatal pneumonia etiologically as (1) transplacental, (2) aspirative, (3) aerogenous, and (4) metastatic septicemic infections. Aspiration, the principal cause of pneumonia, could be of fetid uterine contents, of purulent secretions in the birth canal, or of milk or other material, but foremost in Hess Thaysen's opinion was aspiration of bacteria-laden secretions from the normal birth canal. Browne


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