Risk Factors of Post-Asphyxial Hypoxic-Ischemic Encephalopathy [PAHIE] Abha City – Southwestern Saudi Arabia: A Case-Control Study

Abstract

A case-control study of neonatal encephalopathy was conducted in Abha General Hospital to determine some possible risk factors of encephalopathy. A total of 57 full term infants with evidence of neonatal encephalopathy at 6-24 hours after birth were recruited over a period of 3 years, and compared with the same number of a control group of normal newborns. The cumulative incidence of neonatal encephalopathy was 4.9 per 1000 live births [95% CI: 3.1 to 6.3]. Moderate or severe encephalopathy occurred in about 63% of all infants, with seizures in 67%. All of the 57 [100%] infants with encephalopathy required one or more of the resuscitation measures compared with 8 [14%] of the control. Significant antepartum risk factors of encephalopathy include: primiparity [OR=3.13], no accessibility to antenatal care [OR=1.89], and pregnancy-induced hypertension [OR=2.13]. Significant possible labor and delivery risk factors include: no cephalic presentation [OR=2.76], meconium stained amniotic fluid [OR=4.18], fetal bradycardia [OR=5.23], abnormal fetal heart rate [OR=2.34], antepartum haemorrhage [OR=4.32], instrumental delivery [OR=2.1], and prolonged 2nd stage of labor [OR=6.67]. In conclusion, both antepartum and intrapartum factors are important in the causation of neonatal encephalopathy in Abha City. Improvement of both antenatal care and care during delivery is a necessity.