Low Birth, Prematurity, and Pre-Eclampsia as Risk Factors of Neonatal Asphyxia

Abstract

Background: Asphyxia neonatorum is the condition of an infant who does not breathe spontaneously and regularly immediately after birth. This condition is accompanied by hypoxia, hypercapnia, and ends with acidosis. Long-standing asphyxia can cause brain damage and death. This study aimed to investigate risk factors of asphyxia in Nganjuk Hospital, East Java. Subjects and Method: This was an analytic observational study with a case control design. The study was conducted in Nganjuk Hospital, East Java, in July 2018. A total sample of 150 neonates was selected by fixed disease sampling, consisting of 50 neonates with asphyxia and 1oo neonates without asphyxia. The dependent variable was asphyxia. The independent variables were low birth weight, preterm birth, and pre eclampsia. The data were obtained from medical record and analyzed by a multiple logistic regression. Results: The risk of asphyxia increased with low birth weight (OR= 2.58; 95% CI = 3.80 to 46.15; p<0.001), premature birth (OR= 1.27; 95% CI= 1.23 to 10.25; p= 0.019), and pre-eclampsia (OR= 3.74; 95% CI= 12.54 to 141.05; p <0.001). Conclusions:The risk of asphyxia increases with low birth weight, premature birth, and preeclampsia.

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

“…In this meta-analysis, fetal distress was significantly associated with higher odds of birth asphyxia. 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 ].…”

“…Moreover, this meta-analysis found preeclampsia to be associated with birth asphyxia, which is consistent with the findings of studies conducted in Nigeria [ 61 ], Cameroon [ 66 ], Pakistan [ 69 ], Indonesia [ 64 , 72 , 75 ] and India [ 79 ]. One probable explanation for this is that preeclampsia is a progressive disorder and, in most cases, labour needs to be induced at around the 34 th to 38 th week of pregnancy to safeguard the health of the mother and the foetus [ 97 ].…”

“…These findings could be attributed to the fact that primiparas do not usually receive care during pregnancy, they are less interested in the demands of the pregnancy and often neglect maternal care services [ 74 ]. Low-birth-weight babies were found to be at greater risk of developing birth asphyxia than babies with a normal birth weight, a finding which is in line with studies carried out in Nigeria [ 61 ], Pakistan [ 60 , 65 , 75 ], Zambia [ 62 ] and Indonesia [ 64 , 75 ]. A possible reason for this finding may be due to the fact that birth asphyxia occurs because of a lack of pulmonary surfactant, with the underdevelopment of the lungs, added to the fact that the respiratory muscles are still weak and the ribs can easily become curved [ 76 , 77 ].…”

“…The results of this meta-analysis also revealed that the risk of developing birth asphyxia is higher in relation to preterm birth than full-term birth. This finding is supported by studies conducted in Pakistan [ 65 , 71 ], Zambia [ 62 ], Indonesia [ 64 , 75 ] and India [ 79 ], which all reported that premature babies were more likely to develop birth asphyxia than full-term babies. The reason for this could be that a premature baby’s organs are not yet fully mature, which means that the respiratory system, especially the baby’s lungs, cannot work optimally [ 88 ].…”

Adverse Neonatal Outcome are More Common among Babies Born by Cesarean Section than Naturally Born Babies at Public Hospitals in Eastern Ethiopia: A Comparative Prospective Follow-Up Study at Eastern Ethiopia

“…56 This might be explained by the threat of anemia, CPD, pre-eclampsia, preterm births, vacuum extraction, and low birth weight which are expected in this group of women, leading them to adverse neonatal outcomes. 57 …”