Perinatal Factors Leading to Birth Asphyxia among Term Newborns in a Tertiary Care Hospital

Objective: To determine various perinatal factors leading to birth asphyxia among term newborns in a tertiary care hospital.
Methods In a cross sectional study, a total of 196 asphyxiated cases were selected through consecutive non-probability sampling technique from neonatal intensive care unit (NICU) of a tertiary care Military Hospital in Pakistan from 1st December 2012 to 1st December 2013. Data obtained was analyzed using SPSS version 15.0. Descriptive statistics were used to calculate means, standard deviations and frequencies. Stratification with respect to maternal age, gestational age, newborns weight, parity and gravidity was done and post stratification chi-square test was applied to find statistical significance.
Findings: Out of 196 cases, 125 (64%) were males and 71 females (36%). Mean maternal age was 27.04+4.97 years and gestational age of babies was 39.86+1.24 weeks. Majority (57.14 %) of 112 mothers were 1-3 para and ≥4 parity was recorded in 84 (42.86%) cases. Majority (64.80%) of the 127 mothers were 1-3 gravida while 69 (35.20%) had ≥4 gravidity, mean of 3.45+0.87. Mode of delivery as a factor leading to birth asphyxia was found in 32.14% (n=63) cesarean section, 44.39% (n=87) spontaneous vertex delivery, and instrumental delivery in 23.47% (n= 46). Prolonged second stage of labor reported in 72% (n=141), 29.08% (n=57) had prolonged rupture of membranes, 7.65% (n=15) had meconium staining, 5.61% (n=11) had multiple births, 21.94% (n=43) had maternal fever, and 58.84% (n=113) had anemia at delivery.
Conclusion: Birth asphyxia is a preventable problem and long term neurological sequelae almost untreatable. Timely identification of the perinatal risk factors and their prompt solution can prevent and reduce the neonatal morbidity and mortality from birth asphyxia. Early identification of high-risk cases with improved antenatal and perinatal care can further decrease such high mortality.

Keywords
Birth Asphyxia; Perinatal Risk Factors; Frequency; Meconium Aspiration; Pakistan