Prevalence of Perinatal Asphyxia in Neonates at a Tertiary Care Hospital: A Descriptive Cross-sectional Study

Manandhar, Sunil Raja; Basnet, Rydam

doi:10.31729/jnma.4550

Cited by 8 publications

(11 citation statements)

References 13 publications

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“…The overall incidence of BA reported in developed countries ranges from 1.6 to 24% varying by the type of study (single or multicenter or population based) and the operational definition of BA [22][23][24]. Multi-centric study in South India reported incidence of 24% [25] and 36% in a single center study in Nepal [26]. Similar, incidence of BA has been reported from systematic reviews and metaanalysis in Africa range from 15.9 to 22.3% [12,23,27].…”

Section: Discussionmentioning

confidence: 59%

A multicenter study of incidence, risk factors and outcomes of babies with birth asphyxia in Nepal

et al. 2021

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Background Perinatal events which result in compromised oxygen delivery to the fetus can lead to Birth Asphyxia (BA). While the incidence, risk factors and outcomes of BA have been characterized, less is known in low resource settings. Aim To determine the incidence of Birth Asphyxia (BA) in Nepal and to evaluate associated risk factors and outcomes of this condition. Methods A nested observational study was conducted in 12 hospitals of Nepal for a period of 14 months. Babies diagnosed as BA at ≥37 weeks of gestation were identified and demographics were reviewed. Data were analyzed using binary logistic regression followed by multiple logistic regression analysis. Results The incidence of BA in this study was 6 per 1000 term livebirths and was higher among women 35 years and above. Predictors for BA were instrumented vaginal delivery (aOR:4.4, 95% CI, 3.1–6.1), fetal distress in labour (aOR:1.9, 95% CI, 1.0–3.6), malposition (aOR:1.8, 95% CI, 1.0–3.0), birth weight less than 2500 g (aOR:2.0, 95% CI, 1.3–2.9), gestational age ≥ 42 weeks (aOR:2.0, 95% CI, 1.3–3.3) and male gender (aOR:1.6, 95% CI, 1.2–2.0). The risk of pre-discharge mortality was 43 times higher in babies with BA (aOR:42.6, 95% CI, 32.2–56.3). Conclusion The incidence of Birth asphyxia in Nepal higher than in more resourced setting. A range of obstetric and neonatal risk factors are associated with BA with an associated high risk of pre-discharge mortality. Interventions to improve management and decrease rates of BA could have marked impact on outcomes in low resource settings.

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Section: Discussionmentioning

confidence: 59%

A multicenter study of incidence, risk factors and outcomes of babies with birth asphyxia in Nepal

et al. 2021

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“…Birth asphyxia is the leading cause of early newborn death in the world, accounting for 23% of all neonatal deaths. Every year, between 4 and 9 million babies are born, of which 1.2 million die and a similar number acquire serious neurodisabilities such as cerebral palsy, epilepsy, and developmental delay (Manandhar and Basnet, 2019).…”

Section: Introductionmentioning

confidence: 99%

Lactate and S100 protein as early biochemical indicators of birth neonatal asphyxia caused by intrauterine umbilical cord strangulation: a medicolegal view

Fakher

El-Shafey

Diab

et al. 2022

Zagazig Journal of Forensic Medicine

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Background: From a forensic pathologist's perspective, there are several aspects of the perinatal postmortem that are particularly important if the baby was born alive or dead. In cases of litigation for perinatal morbidities occurring in hospitals, access to the obstetric and neonatal notes if the baby is born alive and dies a few hours or days later is essential to reach a correct interpretation and conclusion. Hypoxic ischemic encephalopathy (HIE) after prenatal asphyxia is an important cause of neonatal morbidity and long-term neurological disability. It has many causes including intrauterine strangulation by umbilical cord (nuchal cord). Failure of early diagnosis of neonatal asphyxia and its treatment is considered a medicolegal negligence against the doctors. Aim: The present study aimed to use cord blood lactate & S100 protein levels as early markers of neonatal hypoxia caused by nuchal cord to minimize the risk of medicolegal liabilities against the doctors and hospitals. Methods: This is a comparative cross-sectional study conducted on 30 hypoxic neonates due to intrauterine cord strangulation. Lactate & S100 protein levels in the cord blood were measured. These were compared to 30 apparently healthy neonates matched in age, sex and body weight as a control group. Results: Lactate & S100 protein levels in cord blood were a higher significant difference in HIE neonates than control group. In conclusion: lactate & S100 protein levels in cord blood could be used as an early marker for diagnosis of neonatal HIE.

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“…Perinatal asphyxia is a condition characterized by fetal oxygen deprivation that leads to the death of approximately 1 million children and disability of another 1 million annually (Manandhar and Basnet 2019). It occurs during the antepartum, intrapartum, or perinatal period.…”

Section: Introductionmentioning

confidence: 99%

Posttreatment Strategy Against Hypoxia and Ischemia Based on Selective Targeting of Nonnuclear Estrogen Receptors with PaPE-1

et al. 2021

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Newly synthesized Pathway Preferential Estrogen-1 (PaPE-1) selectively activates membrane estrogen receptors (mERs), namely, mERα and mERβ, and has been shown to evoke neuroprotection; however, its effectiveness in protecting brain tissue against hypoxia and ischemia has not been verified in a posttreatment paradigm. This is the first study showing that a 6-h delayed posttreatment with PaPE-1 inhibited hypoxia/ischemia-induced neuronal death, as indicated by neutral red uptake in mouse primary cell cultures in vitro. The effect was accompanied by substantial decreases in neurotoxicity and neurodegeneration in terms of LDH release and Fluoro-Jade C staining of damaged cells, respectively. The mechanisms of the neuroprotective action of PaPE-1 also involved apoptosis inhibition demonstrated by normalization of both mitochondrial membrane potential and expression levels of apoptosis-related genes and proteins such as Fas, Fasl, Bcl2, FAS, FASL, BCL2, BAX, and GSK3β. Furthermore, PaPE-1-evoked neuroprotection was mediated through a reduction in ROS formation and restoration of cellular metabolic activity that had become dysregulated due to hypoxia and ischemia. These data provide evidence that targeting membrane non-GPER estrogen receptors with PaPE-1 is an effective therapy that protects brain neurons from hypoxic/ischemic damage, even when applied with a 6-h delay from injury onset.

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Prevalence of Perinatal Asphyxia in Neonates at a Tertiary Care Hospital: A Descriptive Cross-sectional Study

Cited by 8 publications

References 13 publications

A multicenter study of incidence, risk factors and outcomes of babies with birth asphyxia in Nepal

A multicenter study of incidence, risk factors and outcomes of babies with birth asphyxia in Nepal

Lactate and S100 protein as early biochemical indicators of birth neonatal asphyxia caused by intrauterine umbilical cord strangulation: a medicolegal view

Posttreatment Strategy Against Hypoxia and Ischemia Based on Selective Targeting of Nonnuclear Estrogen Receptors with PaPE-1

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