<p>Risk Factors of Perinatal Asphyxia Among Newborns Delivered at Public Hospitals in Addis Ababa, Ethiopia: Case–Control Study</p>

Abstract

Background: Perinatal asphyxia determines the newborn's future health status and viability with risk factors yet to be completely understood. It measures the status of the healthcare delivery of an organization including antenatal, intranatal, and postnatal care. In Ethiopia, 31.6% of neonatal mortality was attributed to perinatal asphyxia. This study aimed to assess the risk factors of perinatal asphyxia. Methods: An unmatched case-control study was conducted on 213 (71 cases selected using lottery method and 142 controls systematically) subjects in Addis Ababa from November 1, 2018 to June 30, 2019. Data were collected using a structured questionnaire through face-toface interviews, entered to Epi data version 4.4, and exported to SPSS version 25 for analysis. Logistic regression was used for analysis. Variables with p< 0.25 in bivariate analysis were taken to multivariable analysis. Statistical significance was declared at P<0.05 and findings were presented using texts and tables. Results: A total of 210 newborns (70 cases and 140 controls) and their mothers were included with an overall response rate of 98.5%. Antepartum hemorrhage [AOR=7.17; 95% CI 1.73-29.72], low birth weight [AOR=2.87; 95% CI 1.01-8.13], preterm birth [AOR=3.4; 95% CI 1.04-11.16], caesarean section delivery [AOR=2.75; 95% CI 1.01-7.42], instrumental delivery [AOR=4.88; 95% CI 1.35-17.61], fetal distress [AOR=4.77; 95% CI 1.52-14.92] and meconium-stained amniotic fluid [AOR=9.02; 95% CI 2.96-30.24] were significantly associated with perinatal asphyxia. Hence, efforts ought to go to improve the quality of antenatal and intra-natal services.

Determinants of Birth Asphyxia Among Newborns in Debre Berhan Referral Hospital, Debre Berhan, Ethiopia: a Case-control Study

“…Less than or equals to two ANC follow up by the mothers were 4.6 times higher odds of developing asphyxiated newborns than mothers who have more than four ANC follow up. This nding was inconsistent with the study conducted in Ethiopia [13,23,25]. This difference may be due to the number of health facilities included in the study and study period.…”

“…Mal-presentation of foetus is associated with premature rupture of membrane; this premature rupture of membrane could leads to umbilical cord accidents occur with sub sequent asphyxia at birth [14]. But, the nding was inconsistent with previous studies conducted in Ethiopia [13,23]. This difference might be due to the difference in the study population and the study design.…”

“…Many studies in different parts of Ethiopia showed that parity [9], anemia [10,11], antepartum hemorrhage [12], prolonged labor [9], preterm birth [12], meconium-stained liquor [12,13], pregnancyinduced hypertension [10], and mode of delivery [14] were signi cant predictors of birth asphyxia. However, information related to determinants of newborn asphyxia in Debre Berhan referral hospitals is limited.…”

Perinatal Asphyxia and Its Associated Factors among Live Births in the Public Health Facilities of Bahir Dar City, Northwest Ethiopia, 2021

“…According to the reports of different studies conducted in Ethiopia, it was shown that the prevalence of perinatal asphyxia ranges from 12.5% to 32.8% [20,21]. Different findings in different countries show that primiparity, complications during pregnancy like preeclampsia/eclampsia and antepartum hemorrhage (APH), intrapartum complication like fever, cord around fetal neck, umbilical cord prolapse, malpresentation, prolonged labor, prolonged rupture of membranes (PROM) and administration of uterotonic drugs, prematurity, low birth weight (LBW), maternal age, and medical complication were identified as risk factors of perinatal asphyxia [20][21][22][23][24][25][26][27][28][29][30][31][32][33], while a retrospective study done in Ghana shows that the use of partographs during labor was associated with a reduced incidence of birth asphyxia [31]. Despite Ethiopia's remarkable success in achieving the MDG-4 goals before five years, the decrement in NMR was comparatively low after that success and at the end of the MDG era, the government of Ethiopia is again running to address the SDGs to decrease NMR by 2030 to at least 12/1000 live births [12,18,19,34,35].…”

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

“…Birth trauma is damage that occurs as a result of physical pressure during the birthing process, usually during transit through the birth canal. 39 …”