Analysis of pathomorphological and morphometric changes in the organs of the adrenal-thymic system in newborns who died from respiratory distress syndrome
Received: 2026-03-26
Published: 2026-06-29
Abstract
Aim. To characterize the morphology of the adrenal glands and thymus in preterm newborns who died from respiratory distress syndrome (RDS) and to assess their integrated interrelationship.
Materials and Methods. A retrospective descriptive analysis was performed on adrenal and thymic tissues from 185 newborns with a gestational age of 26–32 weeks who underwent postmortem examination at the Fergana Regional Bureau of Pathological Anatomy between 2020 and 2024 (total sample N=185; clinically and morphologically confirmed RDS group n=155: 0–7 days n=95, 8–28 days n=60; non-RDS control group n=30). Tissue specimens were stained with hematoxylin and eosin. Quantitative data were expressed as M±m, and between-group differences were assessed using Student’s t-test (p<0.05).
Results. The zona glomerulosa of the adrenal cortex remained in a primordial state in all cases, while lipid inclusions in spongiocytes of the zona fasciculata were sparse or absent. Venous congestion and diapedetic hemorrhages were observed in both the cortical and medullary layers in all cases. Mean adrenal gland weight was 2.08±0.3 g during the acute 0–7-day period and 3.05±0.04 g at 8–28 days, both significantly lower than the control value (4.01±0.05 g). Thymic weight was 4.05±0.06 g and 8.02±0.09 g, respectively, remaining below age-related norms but showing signs of compensatory enlargement relative to the severity of adrenal insufficiency (lymphocyte apoptosis: 54.8±0.05% at 0–7 days, 32.4±0.01% at 8–28 days; ≈5% in controls). In cases with a low Apgar score (0–3 points at 1 minute), regional mortality reached 70–80%; this figure was derived from regional clinical reports and was not calculated separately within the present study.
Conclusion. Structural immaturity of the adrenal glands was accompanied by compensatory involutive-hyperplastic changes in the thymus and may represent an important morphological factor associated with mortality in neonatal RDS. Further controlled statistical studies are required to confirm this relationship.
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