Abstract
Objective: To assess risk factors and outcome in the early neonatal period of babies who were asphyxiated at birth. Methodology: This was a retrospective study conducted at Tribhuvan University Teaching Hospital (TUTH) over a period of one year from 15th Feb 2007 to 14th Feb 2008. All the term babies who had Apgar score of less than < 6 at 1 minute of birth were included. Detailed maternal risk factors during pregnancy and labor were analyzed. The newborn babies who required admission in neonatal unit were again analyzed for development of hypoxic ischemic encephalopathy (HIE) and their outcome. Results: During the study period, out of 3594 term babies, 327 babies (9%) were asphyxiated. Of the total asphyxiated babies, 85% and 15% had moderate and severe asphyxia, respectively, at 1 minute of birth. Out of these asphyxiated babies, 51% and 7% had intrapartum and maternal risk factors, respectively. Intrapartum risk factors like meconium stained liquor, non-vertex presentation, and fetal heart rate abnormalities accounted for 4 fold risk of asphyxia. Of these babies, 26% required admission in nursery and 29% developed hypoxic ischemic encephalopathy. Among the admitted babies 6% expired, 2% left against medical advice and rest were discharged. Conclusion: Early identification and close monitoring of high risk mothers studies with maintaining partograph during labor will help to reduce neonatal asphyxia. Key words: Asphyxiated babies doi:10.3126/jnps.v29i1.1592 J. Nepal Paediatr. Soc. Vol.29(1) p.3-5
Highlights
Antenatal factors were identified in seven percent (7%) of the asphyxiated babies and pregnancy induced hypertension was found to be most common factor (Figure 1) Intrapartum risk factors were seen in fifty one percent (51%) and the major risk was due to meconium stained liquor which was found in two third of the asphyxiated babies
When comparing asphyxiated and non-asphyxiated babies, it was seen that intrapartum risk factors like meconium stained liquor, non vertex presentation, and fetal heart rate abnormality accounted for four fold risk for asphyxia
Several studies have attempted to evaluate the incidence of asphyxia and its risk factors
Summary
It was a retrospective study conducted at Neonatal Unit, TUTH. The study included the newborn babies delivered over a period of 1 year starting form 15th February, 2007 to 14th February, 2008. Criterion to diagnose birth asphyxia in the present study was having Apgar score < 6 at 1 minute of birth. Out of 3986 total deliveries, only term babies of > 37 weeks who had Apgar score of < 6 at 1 minute of birth were included. Apgar score of 4-6 and
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