Abstract
Birth asphyxia is one of the leading causes of death in low and middle-income countries and the prominent cause of neonatal mortality in Ethiopia. Early detection and managing its determinants would change the burden of birth asphyxia. Thus, this study identified determinants of birth asphyxia among newborns delivered in public hospitals of West Shoa Zone, central Ethiopia. A hospital-based unmatched case-control study was conducted from May to July 2020. Cases were newborns with APGAR (appearance, pulse, grimaces, activity, and respiration) score of <7 at first and fifth minute of birth and controls were newborns with APGAR score of ≥ 7 at first and fifth minute of birth. All newborns with birth asphyxia during the study period were included in the study while; two comparable controls were selected consecutively after each birth asphyxia case. A pre-tested and structured questionnaire was used to collect maternal socio-demographic and antepartum characteristics. The pre-tested checklist was used to retrieve intrapartum and fetal related factors from both cases and controls. The collected data were entered using Epi-Info and analyzed by SPSS. Bi-variable logistic regression analysis was done to identify the association between each independent variable with the outcome variable. Adjusted odds ratio (AOR) with a 95% CI and a p-value of <0.05 was used to identify determinants of birth asphyxia. In this study, prolonged labor (AOR = 4.15, 95% CI: 1.55, 11.06), breech presentation (AOR = 5.13, 95% CI: 1.99, 13.21), caesarean section delivery (AOR = 3.67, 95% CI: 1.31, 10.23), vaginal assisted delivery (AOR = 5.69, 95% CI: 2.17, 14.91), not use partograph (AOR = 3.36, 95% CI: 1.45, 7.84), and low birth weight (AOR = 3.74, 95% CI:1.49, 9.38) had higher odds of birth asphyxia. Prolonged labor, breech presentation, caesarean and vaginal assisted delivery, fails to use partograph and low birth weights were the determinants of birth asphyxia. Thus, health care providers should follow the progress of labor with partograph to early identify prolonged labor, breech presentation and determine the mode of delivery that would lower the burden of birth asphyxia.
Highlights
The neonatal period is a very delicate stage of life due to the risk of acquiring potential lifethreatening diseases, and the complexity of the adaptive process [1, 2]
Studies done in Nigeria [7], Nepal [8], and Bangladesh [9] reported that perinatal asphyxia is the cause of 23.9%, 30%, and 39% of newborns’ deaths respectively
The newborns born from mothers with prolonged labor (AOR = 4.15, 95% CI: 1.56, 11.06) and breech presentation (AOR = 5.13, 95% CI: 1.99, 13.21) had 4.15 and 5.13 times more likelihood of birth asphyxia than those who had normal labor and cephalic presentation respectively (Table 3)
Summary
The neonatal period is a very delicate stage of life due to the risk of acquiring potential lifethreatening diseases, and the complexity of the adaptive process [1, 2]. World Health Organization has defined birth asphyxia as a failure to start and maintain breathing at birth [3]. Intrapartum-asphyxia is responsible for about 814,000 deaths per year, and it is the fifth cause of death in under-five children and associated with significant morbidity, ensuing in a burden of 42 million disability-adjusted life years [5]. The proportion of birth asphyxia is 2 per 1000 births in developed countries and it is more than 10 times higher in lowincome countries with limited access to quality obstetrics care during pregnancy, intrapartum and postpartum period [6]. Studies done in Nigeria [7], Nepal [8], and Bangladesh [9] reported that perinatal asphyxia is the cause of 23.9%, 30%, and 39% of newborns’ deaths respectively
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