Birth asphyxia, determinants, and its management among neonates admitted to NICU in Harari and Dire Dawa Public Hospitals, eastern Ethiopia

Abstract

BackgroundDespite a declining neonatal mortality rate globally, Ethiopia has scored 29–30 deaths per 1,000 live births. Birth asphyxia is a major contributor to neonatal mortality, where 4–9 million newborns develop birth asphyxia each year. This study aimed to assess the prevalence of birth asphyxia, its determinants, and its management among neonates admitted to the NICU in Harari and Dire Dawa public hospitals.MethodsA facility-based cross-sectional study was conducted among 409 randomly selected neonates and their index mothers admitted to neonatal intensive care units of public hospitals in Harari and Dire Dawa from June 20 to August 20, 2021. Data were collected through card review and interviewer-administered questionnaires. The collected data were entered into Epi data version 3.1 and exported to SPSS version 20 for analysis. Logistic regression models were fitted to identify factors associated with birth asphyxia. Adjusted odds ratios along with 95% CIs were estimated to measure the strength of the association, and statistical significance was declared at p-value <0.05.ResultsOne-fifth of neonates [20.8% (95% CI: 16.4, 24.6%)] had birth asphyxia. Neonates born by instrumental delivery (AOR = 2.29, 95% CI: 1.10, 4.76) and neonates born to mother with PIH (AOR = 3.49, 95% CI: 1.47, 8.27), PROM (AOR = 2.23, 95% CI: 1.17, 4.26), and chorioamnionitis (AOR = 3.26, 95% CI: 1.10, 9.61) were more likely to have birth asphyxia compared to their counterpart. Ventilation with a bag and mask 50(58.8), putting on free oxygen 19(22.4), and endotracheal intubation 15(17.6) were taken as management methods.ConclusionOne out of five neonates had birth asphyxia. This urges care providers to adhere to national guidelines of obstetrics and neonatal continuum care. They also need to decrease instrumental delivery and treat PIH, PROM, and chorioamnionitis.

Magnitude of neonatal asphyxia and its predictors among newborns at public hospitals of Wolaita Zone in Southern Ethiopia, 2023

“…In this study, the odds of neonatal asphyxia were higher among neonates born to Primiparous mothers than neonates born to multiparous mothers. This finding is consistent with the result of studies conducted in Pakistan, Nigeria, and Tigray in Ethiopia [ 36 , 37 ]. This consistency might be due to the fact that primipara mothers are more likely to give birth at a younger age, may be more prone for malpresentation, obstructed labor, and longer time to negotiate with the pelvic brim and may fail to progress in labor, resulting in the delivery of an asphyxiated neonate.…”

Time to death and predictors of mortality among asphyxiated neonates in southwest Ethiopia, 2022: prospective cohort study

“…Some trials have attempted to implement novel techniques to prevent morbidity and mortality related to neonatal asphyxia in Ethiopia. High-impact newborn and child health interventions address the particular needs of women and newborns from pre-pregnancy to childhood period, and different interventions are packaged to be delivered at household/community and individualised clinical care levels to improve newborn survival 27 28…”