Incidence, Pattern and Outcome of Birth Injuries as Seen in a Tertiary Hospital in Southern Nigeria

Abstract

Introduction: Birth injuries although inevitable should be avoided to prevent unnecessary neonatal morbidities and mortalities as well as hospital litigations. Aim: To determine the incidence rate, pattern and outcome of birth injuries occurring in the Rivers State University Teaching Hospital. Materials and Methods: An observational prospective study was carried out in the Special Care baby Unit of the hospital. A pre tested proforma was used to collect demographic and pregnancy information from mothers and demographic data, delivery history, type of birth injury and clinical outcome from babies whose parents consented to the study. Results: Thirty-nine of the 5,692 babies delivered during the study period had birth injuries, giving an incidence rate of 6.9 per 1000 live births. The common birth injuries were neurological (26.2%), extracranial (23.8%) and soft tissue injuries (21.4%). Cephalopelvic disproportion (36%), diabetes mellitus in pregnancy (32%) and prolonged labour (20%) were commonly found complications of pregnancy among mothers whose babies had birth injuries. Birth injuries were commoner among males, babies born by normal vaginal delivery and those with birth weights between 2.5-3.9Kg. Neurological injuries were significantly associated with normal vaginal delivery and birth weights of ≥ 4kg while soft tissue injuries were significantly associated with Caesarean section, P value < 0.05. Although majority of them were discharged, mortality rate was 7.7%. Conclusion: Although the incidence of birth injury in this study was low, the morbidity and mortality associated with it are avoidable. Improved antenatal and delivery services are therefore necessary to reduce the incidence of birth injuries. Keywords: Birth injury; Incidence; Pattern; Outcome; Tertiary hospital; Nigeria.

Neonatal birth trauma and associated factors in low and middle-income countries: A systematic review and meta-analysis

“…In the studies that assessed immediate adverse outcomes [ 26 , 46 , 49 – 52 , 59 ], a neonatal death incidence of 5.3% [ 51 ] to 28% [ 52 ] was reported. Profound neonatal hypovolemia secondary to the most clinically significant and potentially life-threatening injury,subgaleal hemorrhage [ 26 , 46 , 50 , 52 ], and sepsis [ 51 ] were important complications of birth trauma that contributed to neonatal death. Another reported adverse outcome included anemia and hyperbilirubinemia that required blood transfusion, and phototherapy respectively [ 26 , 49 , 59 ] ( Table 5 ).…”

“…There were 365,547 live births from Ethiopia [25,26,29,30,32,36], Ghana [18,46], Nigeria [19,[47][48][49][50][51][52][53][54], Cameroon [55], Niger [56], India [20-22, 57, 58], Israel [59], Iran [24,28,33,[60][61][62][63][64], Pakistan [65], Thailand [27], Iraq [31] and Saudi Arabia [23,66]. Nineteen of 37 studies (51.4%) were conducted in African countries [18,19,25,26,29,30,32,36,[46][47][48][49][50][51][52][53][54]…”

Neonatal Birth Trauma and Its Predisposing Factors Among Newborns Admitted to Public Hospitals in Eastern Ethiopia: A Cross-Sectional Study

“…10 However, it is slightly higher than other studies in Addis Ababa Ethiopia (12.3%), 11 (9%) 20 , and India (11.76%). 21 Moreover, the present finding was significantly higher than many studies conducted in Finland (1.6%), 9 India (1.54%), 22 Bangladesh (4.9%), 23 Australia (2.2%), 24 Pakistan (4.11%), 14 Iran (2.2%), 17 (2.7%), 25 Cameroon (1.84%), 16 Western Iraq (1.74%), 8 and Ghana (3.66%). 13 The possible justification for variations in the magnitude of NBT in the current study might be the different in the sample size, study setting (ie, the current study was conducted in a multicenter facility-based study), the infrastructure of health care facilities, skills of birth attendants to attend labor and delivery process, duration of the study period, and inclusion home-based delivery.…”

“…7 Moreover, NBT is a significant cause of short-and long-term deformities and disabilities. 8 The magnitude and risk factors for NBT vary from nation to nation; more importantly, it is determined by the availability of standardized obstetrical care. 9 For instance, the magnitude of the NBT ranges from 12.3% to 24.7% in Ethiopia.…”

Prevalence and associated factors of birth trauma in Ethiopia: A systematic review and meta-analysis

“…Birth trauma is an important contributing factor that raises the burden of ill health and death [ 21 ]. Birth trauma also contributes significantly to both short- and long-term malformations and impairments [ 24 ].…”