Study of risk factors in children with birth asphyxia

Abstract

INTRODUCTIONWorld Health Organisation (WHO) defines Birth asphyxia as failure to initiate and sustain breath-ing in a newborn at birth. 1 It is a temporary interruption of oxygen availability that implies a risky metabolic challenge, even when the insult does not lead to a fatal outcome. Asphyxia results in hypoxemia (lack of oxygen) and hypercapnia (accumulation of carbon diox-ide).The combination of the decrease in oxygen supply (hypoxia) and blood supply (ischemia) re-sults in a ABSTRACT Background: Birth asphyxia is a serious clinical problem worldwide and contributes greatly to neonatal mortality and morbidity. Perinatal asphyxia is the fifth largest cause of under-5 deaths (8.5%) after pneumonia, diarrhea, neonatal infections and complications of preterm birth. Risk factors of birth asphyxia have been divided into antepartum, intrapartum and fetal. Risk factors include increasing or decreasing ma-ternal age, prolonged rupture of membranes, meconium stained fluid, multiple births, non-attendance for antenatal care, low birth weight infants, malpresentation, augmentation of labour with oxytocin, antepartum haemorrhage, severe eclampsia and preeclampsia, ante partum and intrapartum anemia. The objective of this study was to study the risk factors in children with birth asphyxia. Methods: Observational prospective study was conducted on babies delivered in our hospital and requiring resuscitation (basic and/or advanced). Their clinical course was observed and studied in NICU till time of discharge or death. Detailed maternal history was taken for risk factors. Results: The mean age of mothers was 24.28 years which ranged from 20 years to 29 years. Most of the population was from the lower middle and upper lower socioeconomic status as per the Modified Kuppuswamy scale. 51% neonates were born to primiparous mothers. Anemia was widely prevalent in the moth-ers of neonates requiring resuscitation. The maternal risk factors for newborns requiring resuscita-tion were PIH (23.7%) , oligohydramnios (15%),multiple gestation (3.75 %), PROM (2.5%), diabetes mellitus (2.5%) and UTI (2.5%).One third of neonates requiring resuscitation were born to unbooked mothers.In the neonates requiring resuscitation, the male to female ratio was 1:1. The fetal factors associated with resuscitation of newborns were IUGR (33.75%), fetal distress (31.25%), prematurity (26.25%), MAS (12.5%) and malpresentations (5%). Conclusions:The most common maternal risk factors for newborns requiring resuscitation was PIH followed by oligohydramnios, multiple gestation, PROM, diabetes mellitus and UTI.IUGR was the most com-mon fetal risk factor followed by fetal distress, prematurity, MAS and malpresentations. One third of neonates requiring resuscitation were born to unbooked mothers. In There was no gender predomi-nance found in this study.

<p>Risk Factors of Birth Asphyxia Among Neonates Born in Public Hospitals of Tigray, Northern Ethiopia</p>

“…This finding is comparable to studies conducted at Acharya Vinobha Bhave rural hospital in India, Pakistan tertiary hospital in Karachi, Mululago hospital in Uganda, and Phramongkutklao hospital in Thailand. 7,13,15,17,21 This might be attributable to the fact that the non-vertex presentation had an increased risk of umbilical cord prolapse, head entrapment and birth injury which result in oxygen deprivation. 22 In our research, neonates entangled in the cord are 5.67 times more likely to develop asphyxia than those not entangled in the cord.…”

Prevalence and risk factors associated with perinatal asphyxia in newborn infants

“…Previous studies have also indicated that preterm birth is one of the main risk factors associated with perinatal asphyxia (Yadav & Damke, 2017, Pitsawong, 2011, Ilah et al, 2015 probably due to the immaturity of the newborn preterm infants' pulmonary system, leading to respiratory failure (Lee et al, 2008).…”

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

“…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].…”