Factors associated with birth injuries in neonates admitted to the neonatal intensive care unit: a retrospective study in a Ghanaian tertiary care setting

Abstract

Background: A birth injury is structural damage or functional deterioration of the neonate’s body due to a traumatic incident at birth. The prevalence and the type of birth injury vary from place to place. There is paucity of data on the prevalence of birth injuries in Ghana. Objective: The study aimed to determine the prevalence and factors associated with birth injury in neonates admitted in a tertiary institution in Northern Ghana. Methods: This was a quantitative retrospective study carried out on neonates admitted to the neonatal intensive care unit (NICU) of the Tamale Teaching Hospital between January 2018 through December 2019. Results: Out of 5590 neonates admitted to the NICU, 205 were noted to have various forms of birth injury corresponding to a prevalence of 3.66%(37 per 1000 neonates admitted to our unit). Majority were male (n=123/205, 60.0%), most deliveries occurred in the study hospital(n=143/205, 69.75%), and spontaneous vaginal delivery accounted for 70.73% (n=145/205). Extracranial injuries (n=146/221, 66.06%) were the most common form of birth injury. Next was musculoskeletal injuries (n=41/221, 18.55%) with humeral fractures (n=15/221, 6.78%) being the most frequent in this category. Among the neonates with birth injuries there were 23 deaths recorded (11.22%) all but one of whom had associated birth asphyxia. Birth injuries were significantly associated with place of delivery(p=0.029). Out-born babies were more likely to have extracranial injuries (adjusted odds ratio,5.10; 95% CI: 1.53-16.94;p=0.008). Conclusion: Extracranial injuries were the most common in this study. Place of delivery was significantly associated with birth injuries. Building the capacity of health care professionals is essential to reduce incidence of birth injuries. Some of these injuries can be avoided if high risk pregnancies are referred early to institutions that have the resources and skill to deliver such babies.