Prevalence and associated factors of birth asphyxia among live births at Debre Tabor General Hospital, North Central Ethiopia

Wubet Alebachew Bayih,Abebaw Yeshambel Alemu,Getachew Yideg Yitbarek,Aragaw Tesfaw,Biruk Beletew Abate,Habtamu Shimelis Hailemeskel,Yared Asmare Aynalem,Metadel Yibeltal Ayalew,Demeke Mesfin Belay

doi:10.1186/s12884-020-03348-2

Abstract

BackgroundMore than one third of the neonatal deaths at Neonatal Intensive Care Unit (NICU) in Debre Tabor General Hospital (DTGH) are attributable to birth asphyxia. Most of these neonates are referred from the maternity ward in the hospital. Concerns have also been raised regarding delayed intrapartum decisions for emergency obstetrics action in the hospital. However, there has been no recent scientific evidence about the exact burden of birth asphyxia and its specific determinants among live births at maternity ward of DTGH. Moreover, the public health importance of delivery time and professional mix of labor attendants haven’t been addressed in the prior studies.MethodsHospital based cross sectional study was conducted on a sample of 582 mother newborn dyads at maternity ward. Every other mother newborn dyad was included from December 2019 to March 2020. Pre-tested structured questionnaire and checklist were used for data collection. The collected data were processed and entered into Epidata version 4.2 and exported to Stata version 14. Binary logistic regressions were fitted and statistical significance was declared at p less than 0.05 with 95% CI.ResultsThe prevalence of birth asphyxia was 28.35% [95% CI: 26.51, 35.24%]. From the final model, fetal mal-presentation (AOR = 6.96: 3.16, 15.30), premature rupture of fetal membranes (AOR = 6.30, 95% CI: 2.45, 16.22), meconium stained amniotic fluid (AOR = 7.15: 3.07, 16.66), vacuum delivery (AOR =6.21: 2.62, 14.73), night time delivery (AOR = 6.01: 2.82, 12.79) and labor attendance by medical interns alone (AOR = 3.32:1.13, 9.78) were positively associated with birth asphyxia at 95% CI.ConclusionsThe prevalence of birth asphyxia has remained a problem of public health importance in the study setting. Therefore, the existing efforts of emergency obstetric and newborn care should be strengthened to prevent birth asphyxia from the complications of fetal mal-presentation, premature rupture of fetal membranes, meconium stained amniotic fluid and vacuum delivery. Moreover, night time deliveries and professional mixes of labor and/delivery care providers should be given more due emphasis.

Highlights

Birth asphyxia or neonatal asphyxia or asphyxia neonatorum or perinatal asphyxia is defined as “failure to initiate and sustain spontaneous breathing at birth [1,2,3,4]
The prevalence in our study was lower than the prevalence in Jimma zone public hospitals, South West Ethiopia (47.5%) [18] which could be attributed to the fact that our study was conducted at a single general hospital which serves a relatively less complicated referral deliveries than the presence of specialized hospital in Jimma zone public hospitals where more complicated referral deliveries are anticipated including birth asphyxia
In the study area, the burden of birth asphyxia has remained a problem of public health importance

Summary

Introduction

Birth asphyxia or neonatal asphyxia or asphyxia neonatorum or perinatal asphyxia is defined as “failure to initiate and sustain spontaneous breathing at birth [1,2,3,4]. Severe degrees of asphyxia can cause severe multiorgan damage resulting in brain damage, lung dysfunction, cardiomyopathy, renal failure, hepatic failure and necrotizing enterocolitis [7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27] From these damages, brain damage is of the greatest concern because the survivors are likely to have lifetime complications like permanent seizure disorder, intellectual incompetence and motor deficits. The public health importance of delivery time and professional mix of labor attendants haven’t been addressed in the prior studies

Methods

Results

Discussion

Conclusion