Outcome of hospital deliveries of women living at high altitude: a study from Lhasa in Tibet

Abstract

To describe rates of neonatal mortality, low birthweight (LBW), preterm birth and small for gestational age (SGA), and relate outcome to ethnicity and perinatal risk factors of liveborn infants of hospital deliveries in Lhasa. The differences in these variables between ethnic Tibetans and non-Tibetans were also studied. Data were prospectively collected on the outcome of all liveborn infants born in four hospitals in the urban area of Lhasa, Tibet, in 2005. A total of 2540 liveborn infants were recorded. The rates of LBW, preterm birth and SGA were 13.6%, 5.7% and 22.2%, respectively. Neonatal mortality rate was 42/1000 for the infants born alive in the hospitals. Lower GA, vaginal delivery, foetal distress and lack of prenatal care, but not ethnicity, were associated with increased risk of death in multivariate logistic regression. Tibetans had higher BW and lower rates of LBW, SGA, need of oxygen supplementation and maternal hypertension, but higher rates of foetal distress, caesarean section, multiple births and low Apgar scores. This study provided a profile of perinatal-neonatal care of hospital newborn infants in Lhasa, Tibet. The rates of neonatal mortality, LBW and SGA were high. The findings suggest ethnic differences in perinatal-neonatal adaptation to high altitude.