Study of risk factors in children with birth asphyxia
DOI:
https://doi.org/10.18203/2349-3291.ijcp20170701Keywords:
Birth asphyxia, PIH, PROM, IUGRAbstract
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 pre-eclampsia, 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.
References
World Health Organisation. Perinatal mortality: a listing of available information. WHO/frh/msm/96.7.Geneva: WHO; 1996.
United Nations. The Millenium Development Goals Report, 2010. New York; 2010
Gleason C, Devaskar S, Avery M. Avery's diseases of the newborn. Philadelphia, PA: Else-vier/Saunders; 2012.
Chandra S, Ramji S, Thirupuram S. Perinatal asphyxia: multivariate analysis of risk factors in hospital births. India Pediatr. 1997;34(3):206-12.
Padayachee N, Ballot DE. Outcomes of neonates with perinatal asphyxia at a tertiary academic hospital in Johannesburg, South Africa. South African J Ch Health. 2013;7:89-94.
Aslam HM, Saleem S, Afzal R, Iqbal U, Saleem SM, Shaikh MW, et al. Risk factors of birth asphyxia. Ital J Pediatr. 2014;40(1):94.
Chiabi A, Nguefack S, Mah E, Nodem S, Mbuagbaw L, Mbonda E, et al. Risk factors for birth asphyxia in an Urban Health Facility in Cameroon. Iran J Child Neurol. 2013;7(3):46-54.
Lee AC, Mullany LC, Tielsch JM, Katz J, Khatry SK, LeClerq SC, et al. Risk factors for neonatal mortality due to birth asphyxia in southern Nepal: a prospective, community-based cohort study. Pediatr. 2008;121(5):e1381-90.
Laopaiboon M, Lumbiganon P, Intarut N, Mori R, Ganchimeg T, Vogel J, et al. Advanced maternal age and pregnancy outcomes. Obstetric Anesthesia Digest. 2015;35(1):27.
Babu BVA, Devi SS, Kumar BK. Birth asphyxia – incidence and immediate outcome in rela-tion to risk factors and complications. Int J Res Health Sci. 2014;2(4):1064-71.
Etuk SJ, Etuk IS, Ekott MI, Udoma EJ. Perinatal outcome in pregnancies booked for ante-natal care but delivered outside health facilities in Calabar, Nigeria. Acta Trop. 2000;75:29-33.
Akhter S, Momen MA, Rahman MM, Parveen T, Karim RK. Effect of maternal anemia on fetal outcome. Mymensingh Med J. 2010;19(3):391-8.
Dalal CA, Bodar NL. Astudy on birth asphyxia at tertiary health centre. Natl J Med Res. 2013;3:374-6.
Mohan K, Mishra PC, Singh DK. Clinical profile of birth asphyxia in newborn. Int J Sci Tech. 2013;3(1):10-9.
Goswami TM, Patel VN, Pandya NH, Mevada AK, Desai KS, Solanki KB. Maternal anaemia during pregnancy and its impact on perinatal outcome. Int J Biomed Adv Res. 2014;5:99-102.
Rusia U, Madan N, Agarwal N, Sikka M, Sood S. Effect of maternal iron deficiency anaemia on foetal outcome. Indian J Pathol Microbiol. 1995;38:273-9.
Afjeh SA, Sabzehei MK, Esmaili F. Neonatal resuscitation in the delivery room from a ter-tiary level hospital: risk factors and outcome. Iran J Pediatr. 2013;23:675-80.
Bari M, Ullah M, Khatun M. Morbidity and mortality of low birth weight baby. TAJ. 2009;21(1):35-9.