Determinants of birth asphyxia among live birth newborns in University of Gondar referral hospital, northwest Ethiopia: A case-control study

Abstract

BackgroundBirth asphyxia, which accounts for 31.6% of all neonatal deaths, is one of the leading causes of such mortality in Ethiopia. Early recognition and management of its contributing factors would modify the problem. Thus, this study aimed to identify the determinants of birth asphyxia among live births at the University of Gondar Referral Hospital, northwest Ethiopia.MethodsA hospital-based unmatched case-control study was conducted from April to July 2017.Cases were newborn babies with an APGAR score of < 7at 5 minutes of birth; controls were newborn babies with an APGAR score of ≥7 at 5 minutes of birth. Every other asphyxiated baby was selected as a case and every 6th non-asphyxiated baby as a control. A pretested structured questionnaire was used to collect data on maternal sociodemographic characteristics. A pretested structured checklist was used to retrieve data on ante-partum, intra-partum, and neonatal factors of both cases and controls. Data were entered using Epi Info 7 and analyzed using SPSS 20. The bivariate logistic regression analysis was used to identify the relation of each independent variable to the outcome variable. Variables with p values of up to 0.2 in the bivariate analysis were considered for the multiple logistic regression analysis. An adjusted odds ratio (AOR) with a 95% CI and p-value of <0.05 was used to identify significant variables associated with birth asphyxia.ResultsIn this study, prolonged labor (AOR = 2.75, 95% CI: 1.18, 6.94), cesarean section delivery (AOR = 3.58, 95% CI: 1.13, 11.31), meconium stained amniotic fluid (AOR = 7.69, 95% CI: 2.99, 17.70), fetal distress (AOR = 5.74, 95% CI: 1.53, 21.55), and low birth weight (AOR = 7.72, 95% CI: 1.88, 31.68) were factors which significantly increased the odds of birth asphyxia.ConclusionProlonged labor, cesarean section (CS) delivery, meconium stained amniotic fluid (AF), fetal distress, and low birth weight were the determinants of birth asphyxia. Thus, efforts should be made to improve the quality of intra-partum care services in order to prevent prolonged labor and fetal complications, and to identify and make a strict follow up on mothers with meconium stained amniotic fluid.

<p>Risk Factors of Birth Asphyxia Among Neonates Born in Public Hospitals of Tigray, Northern Ethiopia</p>

“…This study is consistent with other previous studies conducted in India hospital, Pakistan in Karachi Tertiary Hospital, Phramongkutklao Hospital in Thailand, Nigeria Delta Tertiary Institute, Mulago Hospital in Uganda, Cameron Yaounde Tertiary Hospital, Gondar University Referral Hospital and Tigray Central Zone Public Hospitals in Ethiopia. 7,[11][12][13][14][15]17,19 The possible explanation could be that meconium-stained AF leads to peripartum inhalation of meconium-stained amniotic fluid, resulting in chemical pneumonitis including inflammation of the pulmonary tissue, mechanical narrowing of the airways and pulmonary air leakage, ending in hypoxia. 20 As for the presentation of neonates, those with nonvertex presentation show a significant association with neonatal birth asphyxia.…”

“…Results: A 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 Recommendations: Intrapartum factors and neonatal factors in the index pregnancy have an association with perinatal birth asphyxia.…”

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.…”

Determinants of birth asphyxia among newborns in Amhara national regional state referral hospitals, Ethiopia

“…Studies from abroad indicated that low birth weight, caesarian section [10-12]; multiple births, lack of antenatal care[13]; maternal age, gravidity, mode of delivery [14], and prolonged labor, meconium stained amniotic fluid and fetal distress [12] were the significant causes of birth asphyxia. However, most of the studies were restricted in single institution and based on secondary data or records which may face to data/info incompleteness.…”