Risk Factors of Perinatal Asphyxia in The Term Newborn at Sanglah General Hospital, Bali-Indonesia

Abstract

Background: Perinatal asphyxia is a leading cause of mortality and morbidity in neonates in developing countries, with an incidence of 1 to 6 per 1,000 live full-term births. It is the second most common cause of neonatal death in Indonesia. Antepartum and intrapartum risk factors have been shown to be associated with perinatal asphyxia. Objective: Our study aimed to determine various factors leading to birth asphyxia among term newborns so that an improvement in newborn asphyxia care planning, analysis. and organization can be made. Methods: It was a retrospective case-control study, conducted at Neonatal Care Unit of the pediatric ward (level I, II, III) in Sanglah General Hospital, the teaching hospital of Udayana University School of Medicine. The data was collected from January to December 2015. The case was neonates diagnosed with birth asphyxia, and the control was neonates without birth asphyxia. The demographic data of both the mother and the neonate were collected from their medical records. All data was entered and analyzed with SPSS 19. Result: As many as 70 neonates were recruited in the study. They were equally divided into case and control group. A multivariate analysis showed instrumental delivery OR 5.51 (95%CI 1.24-24.48, p=0.025), meconium stained amniotic fluid OR 7.58 (95%CI 1.56-36.65, p=0.012), and prolonged rupture of membranes OR 10.61 (95%CI 1.81-62.08 p=0.009) were significant risk factors of perinatal asphyxia in a term newborn. Conclusion: Instrumental delivery, meconium-stained amniotic fluid, and prolonged rupture of membranes were the risk factors of perinatal asphyxia in a term newborn. Early identification of high-risk cases and appropriate measure taken could help in reducing the incidence of perinatal asphyxia.