Determinants of Birth Asphyxia among Newborns in Amhara National Regional State Referral Hospitals, Ethiopia

Abstract

Background Globally, every year, 2.5 million infants die within their first month of life. Neonatal asphyxia is the leading specific cause of neonatal mortality in low- and middle-income countries, including Ethiopia. Therefore, the aim of this study was to identify the determinants of birth asphyxia among newborns admitted in Amhara region referral hospitals, Ethiopia. Methods Facility-based unmatched case-control study was employed among 193 cases and 193 controls of newborns. Newborns admitted to neonatal intensive care units with admission criteria of birth asphyxia and without birth asphyxia were considered as cases (Apgar score<7) and controls (Apgar score>=7) respectively. Data were collected using a structured questionnaire by systematic random sampling technique with proportional allocation, and entered in to Epi-Info version 7 and exported to SPSS version 20 for statistical analysis. Bivariate and multivariable logistic regression models were fitted to identify determinants of birth asphyxia. Results Newborns with low birth weight (<2.5kg) had 8.94 higher odds of birth asphyxia than those whose weight at birth was >=2.5kg at birth (AOR: 8.94, 95% CI: 4.08, 19.56). Newborns born at health centers were 7.36 times more likely to develop birth asphyxia than those born at hospitals (AOR: 7.36, 95% CI: 2.44, 22.13). Newborns born using instrumental delivery were 3.03 times more likely to develop birth asphyxia than those delivered by vaginally (AOR: 3.03, 95% CI: 1.41, 6.49). Newborns from mothers with prolonged labor were 2 times more likely to suffer from birth asphyxia as compared to their counterparts (AOR: 2.00, 95% CI: 1.20, 3.36). Conclusion This study identified prolonged labor, instrumental delivery, delivered at health centers, and low birth weight were identified as determinants of birth asphyxia. Thus, intervention planning towards the identified determinants may be needed to reduce neonatal birth asphyxia.

Determinants of Birth Asphyxia Among Newborns in Debre Berhan Referral Hospital, Debre Berhan, Ethiopia: a Case-control Study

“…Prolonged labour was signi cantly associated with birth asphyxia. This nding was consistent with studies conducted in Cameron [21], Pakistan [16], and Ethiopia [11,[24][25][26]. This could be due to primary, secondary, or tertiary dalliance.…”

“…Less than or equals to two ANC follow up by the mothers were 4.6 times higher odds of developing asphyxiated newborns than mothers who have more than four ANC follow up. This nding was inconsistent with the study conducted in Ethiopia [13,23,25]. This difference may be due to the number of health facilities included in the study and study period.…”

Perinatal asphyxia and its associated factors in Ethiopia: a systematic review and meta-analysis

“…Six studies were included in this category of metaanalysis [13][14][15][16][17][18]. Neonates born with low birth weight were 6.52 times (OR: 6.52, 95% CI: 4.40, 9.65) more likely to develop perinatal asphyxia as compared to those born with normal weight.…”

“…Three studies were included in this category of meta-analysis [16,17,19]. The likelihood of developing perinatal asphyxia among neonates born with assisted instrumental delivery was 4.04 times (OR = 4.04, 95% CI: 2.48, 6.60) more likely to develop birth asphyxia than neonates born with spontaneous delivery.…”

“…Five studies were included in this category of metaanalysis [13,14,16,17,19]. The odd of developing perinatal asphyxia among neonates born from mothers with prolonged labor was 2.79 times (OR = 2.79, 95% CI: 1.98, 3.93) more compared with their counterparts.…”