Factors Associated with the incidence of perinatal asphyxia at Sanjiwani Regional General Hospital, Gianyar, Bali, Indonesia

Abstract

Background: perinatal asphyxia is the second-highest cause of neonatal death in Indonesia. According to the World Health Organization (WHO), perinatal asphyxia is when a baby experiences spontaneous and regular breathing failure immediately after birth. Various risk factors may cause perinatal asphyxia, including maternal, fetal, and placental factors. This study aims to identify the risk factors associated with the incidence of perinatal asphyxia at the Sanjiwani Regional General Hospital, Gianyar. Methods: This research was an observational analytic study with a case-control design involving 114 samples of newborns from January 1 to December 31, 2022, at the Sanjiwani Gianyar Hospital. The case group was selected using a total sampling technique, and the control group using a simple random sampling technique. Data were extracted from the medical records and analyzed using univariate, bivariate, and multivariate methods. Bivariate analysis used Chi-square or Fisher's exact tests, while multivariate analysis used logistic regression. The P-value of <0.05 is considered significant. Results: A total of 57 cases and 57 controls were included in this study. The bivariate analysis found the factors associated with perinatal asphyxia were meconium-stained amniotic fluid (p=0.021; OR=2.742; 95%CI=1.150-6.539), mode of delivery (p=0.003; OR=3.203; 95%CI=1.484-6.913), low birth weight (p=0.002; OR=4.595; 95%CI=1.681-12.561), and prematurity (p=0.006; OR=4.732; 95%CI=1.462-15.322). In multivariate analysis, it was found that meconium-stained amniotic fluid has the strongest association with perinatal asphyxia. Conclusion: There is a significant relationship between meconium-stained amniotic fluid, method of delivery, low birth weight, and prematurity with the incidence of perinatal asphyxia.