Risk Factors For Birth Asphyxia Research Articles

Exploring epidemiological maternal risk factors associated with the cases of birth asphyxia: a study at civil hospital, Ahmedabad

Background: Maternal health is crucial for fetal growth; certain risk factors were identified which can affect development. Birth asphyxia, a preventable condition among the newborns, which can be managed with appropriate care during pregnancy, delivery, and post-delivery. This study aimed to identify maternal risk factors for birth asphyxia in newborns. Early recognition and timely preventive measures can lower the morbidity and mortality linked to asphyxia. Methods: The cross-sectional study was conducted over a one-year period. The mothers of asphyxiated newborns were selected for the study. Data was collected using a pretested, semi-structured questionnaire and analyzed using MS Excel and SPSS 26 Results: 150 mothers were selected for the study based on the inclusion criteria. Among the maternal risk factors, late registered pregnancies and the mother who suffered prolonged labor were significantly associated with the severity of asphyxia. Newborn of pregnant women who had history of consumption of smokeless tobacco had significantly more risk of developing hypoxic ischemic encephalopathy (HIE). Conclusions: To improve neonatal outcomes, focusing on antenatal pediatrics is essential. Early detection and referral of maternal risk factors such as lack of ANC visits, consumption of smokeless tobacco and maternal anemia can prevent adverse outcomes and ensure better care for newborns.

Perinatal Birth Asphyxia Among Newborns at Jiblah Public Health Hospital in Ibb City, Yemen, During Six Years of Conflict and Its Predictive Factors: A Retrospective Cross-Sectional Study.

Birth asphyxia is a major cause of infant death across the world, especially in developing countries, where the issue is significantly underreported and underestimated, particularly in fragile and conflict-affected states. The purpose of this study was to determine the prevalence and risk factors for birth asphyxia in women at Jiblah University Hospital in Ibb, Yemen, and its predictive factors throughout six years of conflict. We conducted a retrospective cross-sectional chart review and analysis of the birth database spanning from June 2013 to September 2019 at Jiblah University Hospital in Ibb, Yemen. We used APGAR (appearance, pulse, grimace, activity, and respiration) scores <7 at both the first- and fifth-minute post-delivery with umbilical cord arterial blood pH <7 (metabolic acidosis) and/or neurologic manifestations (seizures or an altered tone) within the first 24 hours of life to define birth asphyxia cases. Factors associated with birth asphyxia were analyzed using univariate and multivariate regression analysis with an odds ratio (OR) and 95% confidence interval (CI). A total of 5,193 neonates were delivered during the study period. The prevalence of birth asphyxia in 309 (6%) neonates. In a multivariate analysis, illiteracy (OR: 2.90; 95% CI: 0.98-8.41), referred mothers (OR: 3.04; 95% CI: 1.42-6.40), advanced maternal age (OR: 1.05; 95% CI: 1.02-1.07), home delivery (OR: 6.50; 95% CI: 3.09-12.57), prematurity (OR: 1.43; 95% CI: 1.05-1.93), and low birth weight (OR: 3.09; 95% CI: 1.93-4.93) were predictors for birth asphyxia and were statistically significant (p<0.05). In this study, the prevalence of birth asphyxia was equivalent to that of other underdeveloped nations. However, continual attention and treatments are required to lower the risk of birth asphyxia. Illiteracy, referred mothers, advanced maternal age, home delivery, prematurity, and low birth weight were all predictors of birth asphyxia in this research. Most birth asphyxia factors mentioned in this study can be managed through effective prenatal, intrapartum, and postpartum care, as well as a strict following of national obstetrics and neonatal guidelines.

Risk Factors for Birth Asphyxia in Hospital-Delivered Newborns in Dodoma, Tanzania: A Case-Control Study.

Asphyxia at birth remains the leading cause of neonatal morbidity and mortality worldwide, accounting for ∼23% of all neonatal deaths. Although the causes vary from country to country, early identification and treatment of risk factors can improve the situation. To determine the risk factors of birth asphyxia in hospital-delivered neonates in Dodoma, Tanzania. A matched case-control study was conducted from May to July 2017 at Dodoma Region Referral Hospital. Data were collected using a semistructured questionnaire and a standard antenatal care index card. Cases were neonates diagnosed with asphyxia at birth (N = 100), while controls were neonates not diagnosed with asphyxia at birth (N = 300). A binary logistic regression model was used to assess the independent variables associated with birth asphyxia and reported as crude and adjusted odds ratios along with their 95% confidence intervals. A total of 400 newborns and their birth mothers were involved in the study. The average age of the case mothers was 26.9 years (SD = 7.85) and that of the control mothers was 27.24 years (SD = 6.08). Place of residence, anemia, maternal age, prenatal visits attended, use of herbs during labor, previously complicated pregnancy, duration of labor, meconium-stained amniotic fluid, and mode of delivery were predictors of birth asphyxia. The study showed that most predictors of birth asphyxia can be prevented. The results suggest appropriate health education before conception, effective follow-up through prenatal care, early identification and treatment of high-risk pregnant women, and proper monitoring of labor and delivery.

Application of machine learning to identify risk factors of birth asphyxia

BackgroundDeveloping a prediction model that incorporates several risk factors and accurately calculates the overall risk of birth asphyxia is necessary. The present study used a machine learning model to predict birth asphyxia.MethodsWomen who gave birth at a tertiary Hospital in Bandar Abbas, Iran, were retrospectively evaluated from January 2020 to January 2022. Data were extracted from the Iranian Maternal and Neonatal Network, a valid national system, by trained recorders using electronic medical records. Demographic factors, obstetric factors, and prenatal factors were obtained from patient records. Machine learning was used to identify the risk factors of birth asphyxia. Eight machine learning models were used in the study. To evaluate the diagnostic performance of each model, six metrics, including area under the receiver operating characteristic curve, accuracy, precision, sensitivity, specificity, and F1 score were measured in the test set.ResultsOf 8888 deliveries, we identified 380 women with a recorded birth asphyxia, giving a frequency of 4.3%. Random Forest Classification was found to be the best model to predict birth asphyxia with an accuracy of 0.99. The analysis of the importance of the variables showed that maternal chronic hypertension, maternal anemia, diabetes, drug addiction, gestational age, newborn weight, newborn sex, preeclampsia, placenta abruption, parity, intrauterine growth retardation, meconium amniotic fluid, mal-presentation, and delivery method were considered to be the weighted factors.ConclusionBirth asphyxia can be predicted using a machine learning model. Random Forest Classification was found to be an accurate algorithm to predict birth asphyxia. More research should be done to analyze appropriate variables and prepare big data to determine the best model.

Risk factors for birth asphyxia

Introduction. Intrauterine hypoxia and asphyxia during childbirth are the leading causes of infant mortality in the structure of certain conditions arising in the perinatal period.Purpose. To study the involvement of negative events for the fetus in the ante- and intranatal periods in the occurrence of perinatal asphyxia in newborns and identify the main modifiable risk factors that will allow formulating preventive strategies in the development of child hypoxia.Materials and methods. A retrospective assessment of the course of the ante- and intranatal period was carried out according to 50 case histories. Nominal data are presented with indication of absolute and relative values. Sets of quantitative indicators are described by the values of the median (Me) and the lower and upper quartiles (Q1–Q3). The χ2 test was used to compare unrelated samples. Differences were considered statistically significant at p &lt; 0.05. Statistical data processing was carried out using the Microsoft Office 2021 software package.Results: In the group of children with moderate and severe asphyxia at birth, the median gestational age was 36 and 33 weeks. The main ante- and intranatal risk factors for asphyxia of newborns were established in the following percentage: fetoplacental insufficiency – 32%; premature rupture of membranes and medical abortions in history, 30% each; first pregnancy, anemia, obesity, hypertension, smoking, maternal age &gt; 35 years, 18% each; isthmic-cervical insufficiency – 16%; history of antenatal death, threatened miscarriage, vaginitis, 14% each; acute respiratory infections during pregnancy, assisted reproductive technologies (IVF), uterine fibroids – 12% each; oligohydramnios – 8%; polyhydramnios – 6%.Conclusion. The structure of factors that can contribute to the development of asphyxia in newborns is diverse. Understanding the involvement of modifiable risk factors determines the need to build a strategy and tactics to reduce their impact on the development of the pathology under consideration.

Magnitude of birth asphyxia and its associated factors among live birth in north Central Ethiopia 2021: an institutional-based cross-sectional study

BackgroundThe leading cause of neonatal death worldwide is birth asphyxia. Yearly, in the first month of life, 2.5 million children died around the world. Birth asphyxia is a major problem, particularly in developing nations like Ethiopia. The goal of this study was to determine the magnitude of birth asphyxia and the factors that contributed to it among neonates delivered at the Aykel Primary Hospital in north-central Ethiopia.MethodsFrom August 1 to August 31, 2021, a hospital-based cross-sectional study was conducted on 144 live births. An Apgar score less than 7 in the fifth minute of birth authorized the diagnosis of birth asphyxia. Variable contention (P < 0.250) for multivariable analysis was determined after data examination and cleaning. Then, to identify important factors of birth asphyxia, a multivariable logistic regression model with a p-value of 0.05 was developed. Finally, a significant relationship between a dependent variable and independent factors was defined as a p-value less than 0.05 with a 95% confidence interval.ResultsThe majority of the mothers, 71.53%, received at least one Antenatal care visit, and more than half of the newborns were male (62.50%). The percentage of neonates that had asphyxia at delivery was 11.11% (95% CI: 6.3 -16.9%). Male newborns were 5.02 times more probable than female newborns to asphyxiate [AOR: 5.02, 95% CI (1.11–22.61)]. Mothers who have not had at least one Antenatal Care visit were 3.72 times more likely to have an asphyxiated newborn than those who have at least one Antenatal Care visit [AOR: 3.72, 95%CI (1.11–12.42)]. Similarly, mothers who had an adverse pregnancy outcome were 7.03 times more likely to have an asphyxiated newborn than mothers who had no such history [AOR: 7.03, 95% CI (2.17–22.70)].ConclusionBirth asphyxia in newborn has come to a standstill as a major public health issue. The sexual identity of the newborn, Antenatal Care visits, and a history of poor pregnancy outcomes were all found to be significant risk factors for birth asphyxia. These findings have great importance for various stakeholders who are responsible for reducing birth asphyxia; in addition, policymakers should establish and revise guidelines associated to newborn activities and workshops.

Risk Factors of Birth Asphyxia among Newborns at Debre Markos Comprehensive Specialized Referral Hospital, Northwest Ethiopia: Unmatched Case-Control Study.

Despite a global decline in under-five deaths, the neonatal mortality rate remains slow in developing countries and birth asphyxia remains the third cause of neonatal deaths. Globally, neonatal deaths accounts for 45% of under-five deaths, birth asphyxia causes 23-40% of neonatal deaths in Ethiopia. There is limited data on risk factors of asphyxia in Ethiopia, particularly in the study area. Therefore, this study aimed to identify the risk factors of birth asphyxia among newborns. This research followed a hospital-based unmatched case-control study design at Debre Markos comprehensive specialized referral hospital, Northwest Ethiopia, among 372 newborns (124 cases and 248 controls). Data were collected by interviewing index mothers and chart review using a pre-tested questionnaire. Then it was entered in Epi-data version 3.1 and transferred to STATA version 14.0 for analysis. Bivariate and multiple variable logistic regression were carried out to the possible risk factors. Finally, statistical significance was declared using adjusted odds ratio with 95% CI and p-value <0.05. Prolonged labor >12, meconium-stained amniotic fluid, assisted vaginal delivery, gestational age < 37 weeks, noncephalic presentation, comorbidity, birthweight<2500grams were found to be significant factors of birth asphyxia. In this study, Prolonged labor >12 hours, meconium-stained amniotic fluid, assisted vaginal delivery, gestational age < 37 weeks, non-cephalic presentation comorbidity, fetal distress, birthweight<2500grams were found to be risk factors of birth asphyxia were risk factors of birth asphyxia. Therefore, to reduce neonatal mortality associated with birth asphyxia, attention should be given to holistic pregnancy, labor and delivery care, and post-natal care. Moreover, interventions aimed at reducing birth asphyxia should target the identified factors.

Clinical profile and outcome of term asphyxiated neonates in neonatal ICU of rural India

India contributes to one fifth of global live births and more than a quarter of neonatal deaths. Of the total 6.3 million children who died before age 5years, around 2.76 million were neonates, the highest for any country in the world. In India where traditional practices are commonly followed, perinatal asphyxia is an important cause of immediate and long-term morbidity and mortality. To study clinical profile and immediate outcome of term neonates with birth asphyxia. A prospective observational study was conducted in tertiary care NICU of Vadodara district, Gujarat, from May 2017 to June 2018. Full term asphyxiated neonates were included in the study. Risk factors for birth asphyxia, their clinical profile, course and complications were recorded. Immediate outcome of newborns with birth asphyxia outcome was analysed. Out of the total 2702 term live births during the study period, 45 (2.17 %) neonates were born asphyxiated. Most common risk factors were foetal distress 13 (28.89%), intrauterine growth restriction(IUGR) 8(17.78%), meconium stained liquor (MSL) 5(11.11%) cord around neck 9 20.0%), pregnancy induced hypertension (PIH) 5(11.11%) and prolonged labour 9(20%). 20(44.44%) neonates had moderate asphyxia and 25(55.56%) had severe asphyxia.

Risk Factors of Birth Asphyxia Among Neonates Born in Public Hospitals of Tigray, Northern Ethiopia.

IntroductionBirth asphyxia is defined by the World Health Organization as not initiating and maintaining default breathing at birth. Approximately 24% of neonatal deaths occurred annually worldwide due to birth asphyxia. About 3% of the 120 million neonates born each year acquire asphyxia in third world countries. Long-term survivors may experience cerebral palsy, delay in growth, vision, hearing and intellectual deficiency, epilepsy, difficulties with communication and behavior. Thus, this study aims to determine the risk factors of birth asphyxia among neonates who were delivered at public hospitals of Tigray, Ethiopia.Materials and MethodsHospital-based unmatched case-control study design was implemented on 390 samples from January to February 2018. Data were collected by interviews using a structured questionnaire and checklist. The collected data were coded and entered using EpiData version 3.1 statistical software and transported to statistical package for social science (SPSS) version 20 software for analysis. Cross-tabulation and odds ratio with 95% confidence interval were computed. Bivariate logistic regression and multivariable logistic regression were done. Multicollinearity was checked. Goodness of fit was checked by the Hosmer–Lemeshow test.ResultsA total of 260 controls and 130 cases were enrolled in the study. Multivariable logistic regression showed that Primi-parity [AOR 5.5 (CI: 2.5, 12.3)], pre-eclamcia/pregnancy-induced hypertension [AOR12.4 (CI: 4.17, 37.15)], post-term pregnancy [AOR 2.73 (CI: 1.00, 7.55)] meconium-stained liquor [AOR 29.2 (CI: 12.0, 71.1)], cord entangled [AOR 5.67 (CI: 1.66,19.3)] and non-vertex presentation [AOR 5.49 (CI: 2.20,13.7)] were found to be risk factors for perinatal birth asphyxia.Conclusion and RecommendationsIntrapartum factors and neonatal factors in the index pregnancy have an association with perinatal birth asphyxia. The research finding suggests effective antenatal care follow-up and follow-up of labor progress using partograph after labor initiation.

Prevalence and Risk Factors of Birth Asphyxia among Elderly Gravidarum

Prevalence and Risk Factors of Birth Asphyxia among Elderly Gravidarum

Risk factors of birth asphyxia in neonates

Background: Perinatal asphyxia is an insult to fetus or newborn due to lack of oxygen (hypoxia) or lack of perfusion (ischemia) to various organ of sufficient magnitude and duration. Perinatal asphyxia is one of the major causes of early neonatal mortality in India. Objective: To study the risk factors of birth asphyxia in children. Design: Observational prospective study on babies delivered in our hospital and requiring resuscitation. Duration: March 2014 to September 2014. Setting: Department of Paediatrics, Bhaskar Medical College. Participants: 100 babies delivered in our hospital and requiring resuscitation. Methods: All neonates who needed resuscitation at birth were included. Maternal obstetric history was taken which included the gravity, parity, abortions and living issues. Mother’s ANC status was asked. Mother’s ABO Blood group and Rh type was taken. History of maternal health conditions was asked for. History of maternal illness was also taken. Neonatal information was entered next which birth weight, term information and others. Results: The mean age of mothers was 25.3 years. 54% neonates were born to primiparous mothers. Anemia was widely prevalent in the mothers of neonates requiring resuscitation. The maternal risk factors for newborns requiring resuscitation were PIH (22%), oligohydramnios (14%),multiple gestation (4%), PROM (3%), diabetes mellitus (3%) and UTI (5%). One third of neonates requiring resuscitation were born to unbooked mothers. The fetal factors associated with resuscitation of newborns were IUGR (35%), fetal distress (32%), prematurity (31%), MAS (10%) and mal-presentations (4%). Conclusion: The most common maternal risk factors for newborns requiring resuscitation was PIH followed by oligohydramnios, multiple gestation, PROM, diabetes mellitus and UTI. IUGR was the most common fetal risk factor followed by fetal distress, prematurity, MAS and mal-presentations.

Etiological Factors&amp; Clinical Courses of Birth Asphyxia in Rural and Urban Population of Kishanganj District.

Problem statement : perinatal asphyxia, neonatal or birth asphyxia is a medical condition from deprivation of oxygen to a newborn infant long enough during the process to cause physical usually to the brain. And it is almost all neonatal deaths occur in our rural and urban area. Where the majority is delivered at homes with negligible antenatal care and poor prenatal services.Methods: In this collaborative study conducted prospective, descriptive study. As a case of 150 newborn babies and as a control 1190 newborn babies are fulfilled the selection criteria for prenatal and birth asphyxia .Results: Incidence of birth asphyxia in relation to ante partum and intrapartum factors. And shows that mother with complication like eclampsia, APH, PROM, cord accidents, failed progress of labor, obstructive labor &amp; prolong 2nd stage of labor, etc were more likely to deliver asphyxiated baby, and analysis of maternal risk factors for birth asphyxia. Many pathological, biochemical &amp; metabolic changes occurs as a result of birth asphyxia. And the data were analyzed by slandered statistical test, namely, Z test, Chi square test, and uniovariate and ultivariate logistic regression analysis of risk factor.Conclusion: In our study it was observed that, Pregnancy related complication in rural &amp; urban population of Kishanganj district was mostly Eclampsia, pre-eclamptic toxaemia, Oligohydramnios, PROM(M24hr) etc. To prevent birth asphyxia trained personal and neonatal resuscitation equipment should be mandatory in all maternity home/hospital because prevention is the best and be only option to reduce the Pre natal &amp; birth asphyxia.Bangladesh Journal of Medical Science Vol.16(4) 2017 p.554-556

Study of risk factors in children with birth asphyxia

Background: Birth asphyxia is a serious clinical problem worldwide and contributes greatly to neonatal mortality and morbidity. Perinatal asphyxia is the fifth largest cause of under-5 deaths (8.5%) after pneumonia, diarrhea, neonatal infections and complications of preterm birth. Risk factors of birth asphyxia have been divided into antepartum, intrapartum and fetal. Risk factors include increasing or decreasing ma-ternal age, prolonged rupture of membranes, meconium stained fluid, multiple births, non-attendance for antenatal care, low birth weight infants, malpresentation, augmentation of labour with oxytocin, antepartum haemorrhage, severe eclampsia and pre-eclampsia, ante partum and intrapartum anemia. The objective of this study was to study the risk factors in children with birth asphyxia.Methods: Observational prospective study was conducted on babies delivered in our hospital and requiring resuscitation (basic and/or advanced). Their clinical course was observed and studied in NICU till time of discharge or death. Detailed maternal history was taken for risk factors.Results: The mean age of mothers was 24.28 years which ranged from 20 years to 29 years. Most of the population was from the lower middle and upper lower socioeconomic status as per the Modified Kuppuswamy scale. 51% neonates were born to primiparous mothers. Anemia was widely prevalent in the moth-ers of neonates requiring resuscitation. The maternal risk factors for newborns requiring resuscita-tion were PIH (23.7%) , oligohydramnios (15%),multiple gestation (3.75 %), PROM (2.5%), diabetes mellitus (2.5%) and UTI (2.5%).One third of neonates requiring resuscitation were born to unbooked mothers.In the neonates requiring resuscitation, the male to female ratio was 1:1. The fetal factors associated with resuscitation of newborns were IUGR (33.75%), fetal distress (31.25%), prematurity (26.25%), MAS (12.5%) and malpresentations (5%).Conclusions: The most common maternal risk factors for newborns requiring resuscitation was PIH followed by oligohydramnios, multiple gestation, PROM, diabetes mellitus and UTI.IUGR was the most com-mon fetal risk factor followed by fetal distress, prematurity, MAS and malpresentations. One third of neonates requiring resuscitation were born to unbooked mothers. In There was no gender predomi-nance found in this study.

Perinatal Factors Preceding Neonatal Hypoxic-Ischemic Encephalopathy in El-Minia Locality

Objectives: We investigated the risk factors of birth asphyxia in neonates in EL-Minia University Hospital from1 January to 31 December to 2015, to identify leading perinatal risk factors causing birth asphyxia in our locality in order to prevent it. Study design this was a retrospective case - control study. Setting: Neonatal Intensive Care Unit (NICU) of Minia University Hospital. We studied160 neonates. 80 neonates of them full filled the criteria of hypoxic ischemic encephalopathy delivered at 28-41 weeks of gestation from 1 January to 31 December 2015 and admitted to Neonatal Intensive Care Unit (NICU) of El-Minia University Hospitals. In addition to the other 80, neurologically free neonates delivered in the same period included as a control group. Data collected include information about the prenatal period, peripartum period, demographic characteristics, admission and evolution during NICU stay. Results: We found that antepartum, intrapartum and postpartum factors are important risks leading to neonatal encephalopathy. Intrapartum factors were highly associated with birth asphyxia as prolonged 2nd stage first then meconium-stained amniotic fluid and prenatal visits<4 show a statistical significance. Conclusion: The identified risk factors may be useful indicators for defining children at risk of developing hypoxic ischemic encephalopathy, and helpful for targeting individuals for early intervention programmes.

Assessment of Risk Factors and Prognosis in Asphyxiated Infants.

Background:Asphyxia is considered an important cause of morbidity and mortality in neonates. This condition can affect many vital organs including the central nervous system and may eventually lead to death or developmental disorders.Objectives:Considering the high prevalence of asphyxia and its adverse consequences, the present study was conducted to evaluate the risk factors for birth asphyxia and assess their correlation with prognosis in asphyxiated infants.Patients and Methods:This two-year follow-up cohort study was conducted on 260 infants (110 asphyxiated infants and 150 healthy neonates) at Mashhad Ghaem Hospital during 2007 - 2014. Data collection tools consisted of a researcher-designed questionnaire including maternal and neonatal information and clinical/laboratory test results. The subjects were followed-up, using Denver II test for 6, 12, 18, and 24 months (after discharge). For data analysis, t-test was performed, using SPSS version 16.5. P value ≤ 0.05 was considered statistically significant.Results:Of 260 neonates, 199 (76.5%) and 61 (23.5%) cases presented with normal neonatal outcomes and with abnormal neonatal outcomes (developmental delay), respectively. Variables such as the severity of asphyxia (P = 0.000), five-minute Apgar score (P = 0.015), need for ventilation (P = 0.000), and severity of acidosis at birth (P = 0.001) were the major prognostic factors in infants with asphyxia. Additionally, prognosis was significantly poorer in boys and infants with dystocia history (P = 0.000).Conclusions:Prevalence of risk factors for developmental delay including the severity of asphyxia need for mechanical ventilation, and severity of acidosis at birth, dystocia, and Apgar score were lower in surviving infants; therefore, controlling these risk factors may reduce asphyxia-associated complications.

"Risk factors of birth asphyxia".

BackgroundBirth asphyxia is an insult to the fetus or newborn due to failure to breath or breathing poorly, leads to decrease oxygen perfusion to various organs. According to WHO, 4 million neonatal deaths occurred each year due to birth asphyxia. Our goal was to evaluate antepartum, intrapartum, and fetal risk factors of birth asphyxia.MethodsIt was a Retrospective Case control study, conducted at Neonatal Intensive Care Unit of pediatric ward (I, II, III) and in Gynecology wards (I, II, III) of Civil Hospital Karachi, Dow University of Health Sciences. Study was conducted from January 2011-November 2012. Neonates diagnosed with birth asphyxia were considered as “cases” while neonates born either with normal vaginal delivery or by cesarean section having no abnormality were considered as “control”. Demographics of both the mother and neonate were noted and Questions regarding possible risk factors were asked from mother. Ethical issues were confirmed from Institutional review board of Civil Hospital Karachi, Dow University of Health Sciences. All data was entered and analyzed through SPSS 19.ResultOut of total 240 neonates, 123 were “cases” and 117 were “control”. Mean maternal age in “case” group was 24.22 ± 3.38 while maternal age of control group was 24.30 ± 4.04. Significant antepartum risk factors were maternal age of 20–25 (OR 0.30 CI 95% 0.07-1.21), booking status (OR 0.20 CI 95% 0.11-0.37), pre-eclampsia (OR 0.94 CI 95% 0.90-0.98) and primigravidity (OR 2.64 CI 95% 1.56-4.46). Significant Intrapartum risk factors were breech presentation (OR 2.96 CI 95% 1.25-7.02), home delivery (OR 16.16 CI 95% 3.74-69.75) and maternal fever (OR 10.01 CI95% 3.78-26.52). Significant Fetal risk factors were resuscitation of child (OR 23 CI 95% 31.27-1720.74), pre-term babies(OR 0.34 CI 95% 0.19-0.58), fetal distress (OR 0.01 CI 95% 0.00-0.11) and baby weight (OR 0.13 CI 95% 0.05-0.32).ConclusionMeasures should be taken to prevent neonatal mortality with great emphasis on skilled attendance at birth and appropriate care of preterm and low birth weight neonates.

Risk factors for birth asphyxia in an urban health facility in cameroon.

The World Health Organization (WHO) estimates that 4 million children are born with asphyxia every year, of which 1 million die and an equal number survive with severe neurologic sequelae. The purpose of this study was to identify the risk factors of birth asphyxia and the hospital outcome of affected neonates. This study was a prospective case-control study on term neonates in a tertiary hospital in Yaounde, with an Apgar score of < 7 at the 5th minute as the case group, that were matched with neonates with an Apgar score of ≥ 7 at the 5th minute as control group. Statistical analysis of relevant variables of the mother and neonates was carried out to determine the significant risk factors. The prevalence of neonatal asphyxia was 80.5 per 1000 live births. Statistically significant risk factors were the single matrimonial status, place of antenatal visits, malaria, pre-eclampsia/eclampsia, prolonged labor, arrest of labour, prolonged rupture of membranes, and non-cephalic presentation. Hospital mortality was 6.7%, that 12.2% of them had neurologic deficits and/or abnormal transfontanellar ultrasound/electroencephalogram on discharge, and 81.1% had a satisfactory outcome. The incidence of birth asphyxia in this study was 80.5% per1000 live birth with a mortality of 6.7%. Antepartum risk factors were: place of antenatal visit, malaria during pregnancy, and preeclampsia/eclampsia. Whereas prolonged labor, stationary labor, and term prolonged rupture of membranes were intrapartum risk faktors. Preventive measures during prenatal visits through informing and communicating with pregnant women should be reinforced.

Antenatal and intrapartum risk factors for birth asphyxia among emergency obstetric referrals in Mulago Hospital, Kampala, Uganda.

Many perinatal deaths follow birth asphyxia that occurs in newborn babies of women who are referred on developing life-threatening obstetric complications. To determine the antenatal and intrapartum risk factors for severe birth asphyxia among babies delivered by women admitted as emergency obstetric referrals. Case-control study. Mulago hospital, the National Referral Hospital, Kampala, Uganda. Cases were newborn term babies (and their mothers) with a 5-minute Apgar score 4 or less (birth asphyxia). Controls were term newborn babies with a 5-minute Apgar score more than 4. Antepartum and intrapartum risk factors among newborn babies (and their mothers) from socio-demographic characteristics, obstetric complications or labour management. The Odds ratios (OR) for various outcomes were calculated using the Statistical Assistance Software (SAS) version 6.2 (Windows), and are presented with their 95% confidence intervals (C1) and p-values. There was no association between socio-demographic factors and birth asphyxia. Antepartum hospitalization, antepartum or intrapartum anaemia, antepartum hemorrhage and severe pre-eclampsia/eclampsia were significantly associated with birth asphyxia; the respective ORs and 95% C1 were 1.73 (1.09-2.75), 5.65 (3.36-9.50), 2.12 (1.11-4.05) and 10.62 (2.92-38.47). Augmentation of labour with oxytocin, premature rupture of membranes, meconium staining of liquor amnii, vacuum extraction, caesarean section, low birth weight and mal-presentations were significantly associated with birth asphyxia with ORs of 5.76 (2.20-15.05), 2.23 (1.31 -3.37), 6.40 (2.76-14.82), 2.16 (1.28-3.67), 2.36 (1.07-5.20) and 6.32 (3.57-11.20) respectively. Early recognition of these complications among emergency obstetric referrals, followed by prompt and appropriate management, may reduce the perinatal deaths from birth asphyxia.

Influence of Maternal, Obstetric and Fetal Risk Factors on the Prevalence of Birth Asphyxia at Term in a Swedish Urban Population

Birth asphyxia is a perinatal occurrence that, in serious cases, may lead to permanent adverse consequences or death. This retrospective case-control study of term neonates with birth asphyxia, defined as a 5-minute Apgarscore less than 7, had as its goal to explore risk factors for birth asphyxia itself, related hypoxic-ischemic encephalopathy (HIE), and asphyxia-related disability and death. Infants who died of nonasphyxial causes, such as infection or maternal sedation, were not included. Among more than 42,000 live births reviewed for the years 1985 through 1991 in an urban Swedish population were 225 cases of birth asphyxia that were matched with nonasphyxial control cases. The study group included 75 infants with both asphyxia and HIE. Surviving infants were followed for 18 months or longer, and those viewed as neurologically disabled were followed for 1.5 to 3 years longer. Twenty-two infants in the asphyxia group died or developed asphyxia-related neurological disability. Rates of birth asphyxia, pure birth asphyxia, and asphyxia-related HIE during the 7-year review period were, respectively, 6.9, 5.4, and 1.9 per 1000 live births. The asphyxia-related mortality rate was 0.26 per 1000 live births, and the rate of neurological impairment at the 18-month follow-up was 0.2 per 1000. Factors associated with birth asphyxia included single marital status (odds ratio [OR] = 7.1), intrauterine meconium release (OR = 4.1), operative delivery (OR = 8.7), breech delivery (OR = 20.3), and oxytocin augmentation (OR = 2.9). Other associated parameters were cord complications (OR = 15.8) and external compression to aid delivery (OR = 6.2). Significant cardiotocographic (CTG) correlates included repeated late decelerations (OR = 29.4), occasional late or variable decelerations (OR = 2.2), and a lack of accelerations (OR = 5.2). All groups of infants with asphyxia were delivered operatively or instrumentally more often than were the matched control infants. No association was evident between asphyxia and maternal age, smoking, illnesses, time of delivery (day vs. night or seasonal), or previous cesarean delivery. Independent risk factors for HIE included intrauterine meconium release, CTG score, and operative delivery. This is one of the few population-based studies of risk factors for asphyxia and perhaps the first to separately examine risk factors for pure asphyxia, HIE, and asphyxia-related death and disability. Asphyxia was strongly associated with CTG abnormalities, particularly the absence of baseline variability. CTG monitoring definitely is indicated for women given oxytocin augmentation, one of the factors associated with asphyxia in this study.

Maternal factors contributing to asphyxia neonatorum

The objective was to identify maternal risk factors for birth asphyxia, and took the form of a retrospective study over 3 years of 15,964 deliveries. The antenatal and intrapartum course of 68 mothers who delivered babies with birth asphyxia was studied. Babies < 34 weeks/< or = 2000 g at birth were excluded. A 5-min Apgar score < 6 was regarded as abnormal. The incidence of asphyxia neonatorum was 4.6/1000. Most mothers (76 per cent), resided locally, booked (91 per cent), and had satisfactory antenatal clinic attendance (average seven visits). The distribution showed a disproportionately large number of grand multiparas (10 per cent). Labour was characterized by prolonged first (49 per cent) and second (36 per cent) stages with a high incidence of meconium in the amniotic fluid (47 per cent). Most deliveries (53 per cent) were by caesarian section of which 44 per cent were performed for fetal distress. Meconium aspiration was common (34 per cent). High risk signs in labour can be recognized. The judicious use of the partogram, fetal scalp blood pH, and amino-infusion are encouraged.