Prevalence and determinants of asphyxia neonatorum among live births at Debre Tabor General Hospital, North Central Ethiopia: a cross-sectional study.

Wubet Alebachew Bayih,Habtamu Shimelis Hailemeskel,Tadesse Gashaw Tezera,Abebaw Yeshambel Alemu,Demeke Mesfin Belay,Metadel Yibeltal Ayalew

doi:10.4314/ahs.v21i1.49

Wubet Alebachew Bayih, Habtamu Shimelis Hailemeskel + Show 4 more

Open Access

https://doi.org/10.4314/ahs.v21i1.49

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Abstract

More than one third of the neonatal deaths at Neonatal Intensive Care Unit of Debre Tabor General Hospital (DTGH) are attributable to birth asphyxia. Most of these neonates are referred from maternity ward of the hospital. However, there is no recent evidence on the prevalence and specific determinants of birth asphyxia at DTGH. Besides, public health importance of factors like birth spacing weren't addressed in the prior studies. A cross sectional study was conducted on a sample of 240 newborns at delivery ward. The collected data were cleaned, coded and entered into Epi -data version 4.2 and exported to Stata version 14. Binary logistic regression model was considered and statistical significance was declared at P< 0.05 using adjusted odds ratio. The prevalence of asphyxia neonatorum was 6.7 % based on the fifth minute APGAR score. From multi-variable logistic regression analysis, antenatal obstetric complications (AOR = 2.63, 95% CI: 3.75, 14.29), fetal malpresentation (AOR = 3.17, 95% CI: 1.21, 15.20), premature rupture of fetal membranes (AOR = 6.56, 95% CI: 3.48, 18.12) and meconium stained amniotic fluid (AOR = 2.73, 95% CI: 1.76, 14.59) were significant predictors. The prevalence of fifth minute asphyxia neonatorum was relatively low. Fortunately, its predictors are modifiable. Thus, we can mitigate the problem even with our limited resources such as enhancing the existing efforts of antenatal and intra-partum care, which could help early detection and management of any obstetric and neonatal health abnormality."

Highlights

Asphyxia neonatorum or birth asphyxia is defined as “failure to initiate and sustain spontaneous breathing at birth [1, 2]
From multi-variable logistic regression analysis, antenatal obstetric complications (AOR = 2.63, 95% CI: 3.75, 14.29), fetal malpresentation (AOR = 3.17, 95% CI: 1.21, 15.20), premature rupture of fetal membranes (AOR = 6.56, 95% CI: 3.48, 18.12) and meconium stained amniotic fluid (AOR = 2.73, 95% CI: 1.76, 14.59) were significant predictors
The prevalence of birth asphyxia in our study was lower than the study in Nigeria (21.1%)19 which may be attributed to the use of non APGAR score clinical parameters by the Nigerian study that included even out born neonates

Summary

Introduction

Asphyxia neonatorum or birth asphyxia is defined as “failure to initiate and sustain spontaneous breathing at birth [1, 2]. 7-27 From these damages, brain damage is of the greatest concern becausvictim newborns are less likely to survive and even the survivors are more likely to have long-term neurological morbidities like cerebral palsy, permanent seizure disorder, intellectual incompetence and motor deficits, thereby leaving the survivors to be lifetime family burden This in turn has raised the demand for costly technological care of asphyxiated newborns though the treatment outcome is often poor [3,4,5]. More than one third of the neonatal deaths at Neonatal Intensive Care Unit of Debre Tabor General Hospital (DTGH) are attributable to birth asphyxia. Results: The prevalence of asphyxia neonatorum was 6.7 % based on the fifth minute APGAR score. Prevalence and determinants of asphyxia neonatorum among live births at Debre Tabor General Hospital, North Central Ethiopia: a cross-sectional study.

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