Birth asphyxia following delayed recognition and response to abnormal labour progress and fetal distress in a 31-year-old multiparous Malawian woman

Löwensteyn, Yvette N; Housseine, Natasha; Masina, Thokozani; Browne, Joyce L.; Rijken, Marcus J.

doi:10.1136/bcr-2018-227973

Cited by 5 publications

(3 citation statements)

References 39 publications

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“…This finding is consistent with the studies done in Pakistan, Indonesia and India [ 73 , 75 , 82 ]. The possible explanation is that fetal distress mainly results from insufficient placental perfusion or any factor during labor that will impair fetal oxygenation, which can cause further difficulty initiating and sustaining breathing after birth, ending up with asphyxia [ 101 ]. Post term delivery was significantly associated with an increased odds of birth asphyxia.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and risk factors associated with birth asphyxia among neonates delivered in Ethiopia: A systematic review and meta-analysis

Ahmed¹,

Mosa²,

Sultan³

et al. 2021

PLoS ONE

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Background A number of primary studies in Ethiopia address the prevalence of birth asphyxia and the factors associated with it. However, variations were seen among those studies. The main aim of this systematic review and meta-analysis was carried out to estimate the pooled prevalence and explore the factors that contribute to birth asphyxia in Ethiopia. Methods Different search engines were used to search online databases. The databases include PubMed, HINARI, Cochrane Library and Google Scholar. Relevant grey literature was obtained through online searches. The funnel plot and Egger’s regression test were used to see publication bias, and the I-squared was applied to check the heterogeneity of the studies. Cross-sectional, case-control and cohort studies that were conducted in Ethiopia were also be included. The Joanna Briggs Institute checklist was used to assess the quality of the studies and was included in this systematic review. Data entry and statistical analysis were carried out using RevMan 5.4 software and Stata 14. Result After reviewing 1,125 studies, 26 studies fulfilling the inclusion criteria were included in the meta-analysis. The pooled prevalence of birth asphyxia in Ethiopia was 19.3%. In the Ethiopian context, the following risk factors were identified: Antepartum hemorrhage(OR: 4.7; 95% CI: 3.5, 6.1), premature rupture of membrane(OR: 4.0; 95% CI: 12.4, 6.6), primiparas(OR: 2.8; 95% CI: 1.9, 4.1), prolonged labor(OR: 4.2; 95% CI: 2.8, 6.6), maternal anaemia(OR: 5.1; 95% CI: 2.59, 9.94), low birth weight(OR = 5.6; 95%CI: 4.7,6.7), meconium stained amniotic fluid(OR: 5.6; 95% CI: 4.1, 7.5), abnormal presentation(OR = 5.7; 95% CI: 3.8, 8.3), preterm birth(OR = 4.1; 95% CI: 2.9, 5.8), residing in a rural area (OR: 2.7; 95% CI: 2.0, 3.5), caesarean delivery(OR = 4.4; 95% CI:3.1, 6.2), operative vaginal delivery(OR: 4.9; 95% CI: 3.5, 6.7), preeclampsia(OR = 3.9; 95% CI: 2.1, 7.4), tight nuchal cord OR: 3.43; 95% CI: 2.1, 5.6), chronic hypertension(OR = 2.5; 95% CI: 1.7, 3.8), and unable to write and read (OR = 4.2;95%CI: 1.7, 10.6). Conclusion According to the findings of this study, birth asphyxia is an unresolved public health problem in the Ethiopia. Therefore, the concerned body needs to pay attention to the above risk factors in order to decrease the country’s birth asphyxia. Review registration PROSPERO International prospective register of systematic reviews (CRD42020165283).

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Section: Discussionmentioning

confidence: 99%

Prevalence and risk factors associated with birth asphyxia among neonates delivered in Ethiopia: A systematic review and meta-analysis

Ahmed¹,

Mosa²,

Sultan³

et al. 2021

PLoS ONE

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“…This is critical, as several studies in similar contexts within sub-Saharan Africa have shown that neonatal care provision in rural resource-limited settings remains a challenge [2,5,24,27,33]. This study suggests, however, that with similar inputs and improvements as in Neno, comparable improvements in neonatal survival are possible [35][36][37]. In this study, at Neno District Hospital, admissions to the nursery increased vefold as the neonatal ward was developed and expanded.…”

Section: Discussionmentioning

confidence: 87%

Establishment of a neonatal nursery in a rural district hospital in Malawi: A retrospective review of neonatal outcomes in Neno District Hospital (2014 - 2021)

Mvula,

Aron,

Mphande

et al. 2023

Preprint

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Background: Despite efforts to improve neonatal care worldwide, neonatal mortality rates in sub-Saharan Africa,including in Malawi, remain high, with a need for space, equipment, and staff. We evaluated the impact of establishing a district-level neonatal nursery and subsequent strengthening efforts over seven years at Neno District Hospital, Malawi. Methods: We conducted a retrospective cohort study to measure the neonatal outcomes before nursery establishment (study period I, 2014-2015), following the establishment of a nursery (study period II, 2016-2018), and ongoing strengthening efforts (study period III, 2019-2021). We extracted data from neonatal registers and employed descriptive statistics and chi-square tests to compare the overall neonatal outcomes between admission periods. We then performed logistic regression to isolate factors associated with neonates alive atdischarge from the neonatal nursery. Results: In a review of nursery capacity, nursery establishment in 2016 included initial inputs of equipment, medications, and systems with increased support of space, human resources, and additional systems with the transition to a larger nursery in 2019. Of the 1366 neonates observed over the entire study period (2014-2021), the three primary admission diagnoses were birth asphyxia (30%, n=411), sepsis (29%, n=396), and prematurity (21%, n=286). The proportion of neonates discharged alive increased from 62% to 74% to 88% in study periods I, II, and III, respectively. The odds of being discharged alive were four times higher in study period III than in study period I (OR=4.34; 95% CI: 2.6-7.04; p<0.001) and increased sixfold after adjusting for sex (aOR=6.51; 95% CI: 3.69-11.5; p<0.001). Neonates admitted with prematurity were less likelyto be discharged alive (OR=0.56; 95% CI: 0.38-0.82; p=0.003) than other diagnoses. The odds of being discharged alive for neonates weighing 1500-2500 g were five times higher than those weighing <= 1500 g at birth (aOR=5.25, 95% CI=2.61-10.7, p<0.001). Conclusions: Neonatal nursery services and outcomes improved with nursery establishment at Neno District Hospital and improved with increased inputs over seven years. A multidimensionaldecentralized approach at a district hospital with adequate space, staff, equipment, and medications is vital to treating sick neonates and decreasing neonatal mortality.

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“…A number of studies in Malawi have been conducted to address the prevalence of birth asphyxia and its associated factors [12][13][14]. However, little is known on the quality improvement initiates to improve care of neonates with birth asphyxia.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of criterion-based audit in improving quality of neonatal birth asphyxia care at Balaka district hospital in Malawi

Mwalweni,

Chirwa,

Chimala

et al. 2024

Preprint

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Background Birth asphyxia remains one of the leading causes of neonatal deaths worldwide with a higher incidence in resource limited countries such as Malawi. At Balaka district hospital, Birth asphyxia is the primary cause of neonatal mortality accounting for 37.3% of the district’s neonatal deaths. Although various quality improvement initiatives on birth asphyxia such as Helping Babies Breathe have been documented in Malawi, there is limited information on use of criterion based audit (CBA) to enhance the care of neonates with birth asphyxia. This study aimed to evaluate the effectiveness of criterion-based audit in improving quality of neonatal birth asphyxia care at Balaka district hospital in Malawi. Methods A CBA on the care of babies born with birth asphyxia was conducted at Balaka district hospital in Malawi. The care practices were assessed through a retrospective review of 110 cases notes and compared with a locally established standards, by a multidisciplinary team, based on the Malawi guidelines on care of the infant and newborn and World Health Organization manuals. The gaps in current practice were identified, reasons discussed, and recommendations made and implemented. A re-audit was conducted on 110 case notes six months after the initial audit. Results The re-audit showed significant improvements in many of the set criteria for quality care: Checking of vital signs (80% vs. 98.2%; p = 0.000), appropriate investigations check (0.9% vs. 74%; p = 0.000), Thermal support (82.7% vs. 91.8%; p = 0.041), Correct diagnosis (60% vs. 81%; p = 0.001), Correct treatment (18.7% vs. 81%; p = 0.000), Correct Feeding (12.7% vs. 56.4%; p = 0.000), Clinicians’ ward rounds (0% vs. 72%; p = 0.000), and Daily weight check (49.1% vs. 93%; p = 0.000). Additionally, neonatal death decreased from 11% in initial audit to 5% in the re-audit. Conclusion CBA is a low-cost tool that can significantly improve the care of neonates with birth asphyxia in resource-limited countries.

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Birth asphyxia following delayed recognition and response to abnormal labour progress and fetal distress in a 31-year-old multiparous Malawian woman

Cited by 5 publications

References 39 publications

Prevalence and risk factors associated with birth asphyxia among neonates delivered in Ethiopia: A systematic review and meta-analysis

Prevalence and risk factors associated with birth asphyxia among neonates delivered in Ethiopia: A systematic review and meta-analysis

Establishment of a neonatal nursery in a rural district hospital in Malawi: A retrospective review of neonatal outcomes in Neno District Hospital (2014 - 2021)

Evaluation of criterion-based audit in improving quality of neonatal birth asphyxia care at Balaka district hospital in Malawi

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