Risk factors associated with the development of perinatal asphyxia in neonates at Hospital Universitario del Valle, Cali, Colombia, 2010-2011

Abstract

Introduction: Perinatal asphyxia is one of the main causes of perinatal mortality and morbidity worldwide and it generates high costs for health systems; however, it has modifiable risk factors. Objective: To identify the risk factors associated with the development of perinatal asphyxia in newborns at Hospital Universitario del Valle, Cali, Colombia. Materials and methods: Incident cases and concurrent controls were examined. Cases were defined as newborns with moderate to severe perinatal asphyxia who were older than or equal to 36 weeks of gestational age, needed advanced resuscitation and presented one of the following: early neurological disorders, multi-organ commitment or a sentinel event. The controls were newborns without asphyxia who were born one week apart from the case at the most and had a comparable gestational age. Patients with major congenital malformations and syndromes were excluded. Results: Fifty-six cases and 168 controls were examined. Premature placental abruption (OR=41.09; 95%CI: 4.61-366.56), labor with a prolonged expulsive phase (OR=31.76; 95%CI: 8.33-121.19), lack of oxytocin use (OR=2.57; 95% CI: 1.08 -6.13) and mothers without a partner (OR=2.56; 95% CI: 1.21-5.41) were risk factors for the development of perinatal asphyxia in the study population. Social difficulties were found in a greater proportion among the mothers of cases. Conclusions: Proper control and monitoring of labor, development of a thorough partograph, and active searches are recommended to ensure that all pregnant women have adequate prenatal care with the provision of social support to reduce the frequency and negative impact of perinatal asphyxia.

Prevalence and contributing factors of Birth asphyxia among the neonates delivered at Negest Eleni Mohammed memorial teaching hospital, Southern Ethiopia: A cross-sectional study

“…This study also showed that mothers encountering a prolonged second stage of labor were at a greater risk for birth asphyxia with respect to their counterparts. These findings were similar to those of studies conducted in Ethiopia, Colombia and Pakistan [13,15,21]. One reason that babies born after a prolonged labor have a greater risk of birth asphyxia may be due to umbilical cord problems or the stress of too many contractions.…”

“…Antepartum risk factors include severe maternal hypertensive diseases during pregnancy [12,13], antepartum haemorrhage [14,15], history of still birth [16], antenatal care visits [13,14,16], oligohydramnios [13], maternal fever [12, -14, 17] and maternal anaemia [12,13,16,16], young maternal age [12,17,18], advanced maternal age [19], and low educational status (illiterate and primary education level) [16,18]. Intrapartum risk factors include malpresentation [12-14, 16, 20], prolonged second stage of labour [14,15,21], home delivery [12,17], obstructed labour [12,17,22], oxytocin use [14], and meconium stained amniotic fluid [12, 13, 16 , 17]. Fetal risk factors associated with birth asphyxia include low birth weight [12,17], high birth weight [21], multiple gestation [13], tight nuchal cord [14,21], preterm delivery [12,13,21], resuscitation and fetal distress [16,23].…”

Prevalence and contributing factors of Birth asphyxia among the neonates delivered at Nigist Eleni Mohammed Memorial Teaching Hospital, Southern Ethiopia: A cross-sectional study

“…One reason that babies born after a prolonged labor have a greater risk of birth asphyxia may be due to umbilical cord problems or the stress of too many contractions. [15], India [17], and Pakistan [18]. Possibly, the presence of meconium in the amniotic fluid may cause aspiration of meconium-stained amniotic fluid to occur, and this can block small airways, deactivate surfactants and may also inhibit surfactant synthesis, resulting in birth asphyxia [38][39].…”

“…Antepartum risk factors include severe maternal hypotension or hypertensive diseases during pregnancy [13,14], antepartum haemorrhage [15,16], history of stillbirth [17], fewer than four antenatal care visits [14,15,17], oligohydramnios [14], maternal fever [13,15,18], and maternal anaemia [13,14,17], young maternal age [13,18,19], advanced maternal age [20], and low educational status (illiterate and primary education level) [17,19]. Intrapartum risk factors include malpresentation [13-15, 17, 21], prolonged second stage of labour [15,16,22], home delivery [13,18], obstructed labour [13,18,23], oxytocin use [16], and meconium stained amniotic fluid [13,14,15,18]. Fetal risk factors associated with birth asphyxia include low birth weight [15,18], high birth weight [22], multiple gestation [14], tight nuchal cord [15,22], preterm delivery [13,14,22], resusci...…”

“…Intrapartum risk factors include malpresentation [13-15, 17, 21], prolonged second stage of labour [15,16,22], home delivery [13,18], obstructed labour [13,18,23], oxytocin use [16], and meconium stained amniotic fluid [13,14,15,18]. Fetal risk factors associated with birth asphyxia include low birth weight [15,18], high birth weight [22], multiple gestation [14], tight nuchal cord [15,22], preterm delivery [13,14,22], resuscitation, and fetal distress [17,24]. Despite this, a high number of newborn deaths due to birth asphyxia were reported in Ethiopia.…”