RISK FACTORS OF BIRTH ASPHYXIA
Abstract
Background: Birth asphyxia is a serious clinical problem worldwide. There are many reasons ababy may not be able to take in enough oxygen before, during, or just after birth. Damage to braintissues is a serious complication of low oxygen that can cause seizures and other neurologicalproblems. This study was designed to asses the risk factors of birth asphyxia in neonates.Methods: This descriptive, prospective study was conducted in the Department of Paediatrics,Isra University Hospital, Hyderabad, from April 2005 to April 2006. 125 newborn (75 males and50 females) admitted to the neonatal care unit, who were delivered with delayed cry or low apgarscore (<7) were included. Detailed maternal history was taken, regarding their age, gestationalage, and complications, if any. Results: Out of 125 neonatal encephalopathy cases, 28% werediagnosed as suffering with moderate or severe encephalopathy, whereas 36% had mildencephalopathy. Risk of neonatal encephalopathy increased with increasing or decreasing maternalage. Antepartum risk factors included non-attendance for antenatal care (64%). Multiple birthsincreased risk in 4.8%. Intrapartum risk factors included non-cephalic presentation (20%),prolonged rupture of membranes (24%) and various other complications. Particulate meconiumwas associated with encephalopathy in 9.6%. 60% mothers were anemic. Vaginal bleeding wasstrongly associated with birth asphyxia in 34.44% of neonates. 56% of mothers delivered at home,while 28% delivered at a private hospital or maternity home. Only 12% delivered at a tertiary carehospital. Conclusion: Lack of antenatal care, poor nutritional status, antepartum hemorrhage andmaternal toxaemia were associated with higher incidence of asphyxia. Improvements in the publichealth of women with associated gains in female growth and nutrition must remain a longer-termgoal. Early identification of high-risk cases with improved antenatal and perinatal care candecrease such high mortality. Safe motherhood policy is recommended.Key words: Risk factor; Birth asphyxia; Hypoxic ischemic encephalopathy (HIE)References
Leviton A, Nelson KB. Problems with definitions and
classifications of newborn encephalopathy. Pediatr Neurol
; 8(2): 85-90.
Snyder EY, Cloherty JP. Perinatal asphyxia. In: Cloherty JP,
Stark AR, editors. Manual of neonatal care. 4th ed.
philadelphia: Lippincott-willliams & Wilkins; 1998. 515-32.3
[No authors listed] Cerebral palsy, intrapartum care, and a
shot in the foot. Lancet 1989; 2(8674): 1251-2.
Devlin MM. Medical legal highlights: malpractice claims for
birth injuries. J Med Practice 1990; 5:215-8.
Stanley FJ, Blair E. Why have we failed to reduce the
frequency of cerebral palsy? Med J Aust 1991; 154(9):623-6.
Richard E.Behrman, Robert M.Kliegman, editors. Nelson
text book of pediatrics 17 th ed. United States of America: Hal
B. Jenson; 2004.
Shadid M, Moison R, Steendijk P, Hiltermann L, Berger HM,
van Bel F. The effect of antioxidative combination therapy
on post hypoxic-ischemic perfusion, metabolism, and
electrical activity of the newborn brain. Pediatr Res 1998;
(1): 119–124.
J Ayub Med Coll Abbottabad 2007; 19(3)
World Health Organization. Perinatal mortality: a listing of
available information. WHO/FRH/MSM/96.7. Geneva:
WHO, 1996
Fenichel GM. Hypoxic-ischaemic encephalopathy in the
newborn. Arch Neurol 1983; 40(5): 261-6.
Amiel-Tison C, Ellison P. Birth asphyxia i n the fullterm
newborn: early assessment and outcome. Dev Med Child
Neurol. 1986; 28(5): 671-682
Connell J, Oozeer R, de Vries L, Dubowitz LM, Dubowitz V.
Continuous EEG monitoring of neonatal seizures: diagnostic
and prognostic considerations. Arch Dis Ch ild. 1989; 64(4):
-8.
Levene ML, Kornberg J, Williams TH. The incidence and
severity of post -asphyxial encephalopathy in full term
infants. Early Hum Dev 1985; 11(1): 21-6
Shaheen F. Clinical audit of perinatal mortality in a teaching
Hospital. Pak J Obstet Gynaecol 1997; 10(3): 27-30.
UNICEF. The state of the world’s children 2005. New York:
UNICEF; 2005.
Chishty AL, Iqbal MA, Anjum A, Maqbool S. Spectrum of
multiorgan systemic involvement in birth asphyxia. Pak
Pediatr J 2001; 25: 81-7.
Ejaz I, Khan HI, Baloch GR. Neonatal mortality: Report
from a tertiary hospital in Lahore/causes and outcome. Pak
Paed J 2001; 25(2): 35-8.
Maqbool S, Saeed M, Khan SR. Birth asphyxia. J Pak Med
Assoc 1998. 48: 217-9.
Arif MA, Nizami SK. A study of 10566 newborns babies.
Pak Pediatr J 1985; 9: 20-5.
Baloch R, Ababsi KA, Malik B. Perinatal mortality: a
hospital Based survey. Pak J Obstet Gynaecol 1996; 9(2,3):
-5.
Hagberg G, Hagberg B, Olow I. The changing panorama of
cerebral palsy in Sweden 1954-1970. III: The importance of
foetal deprivation of supply. Acta Paediatr Scand. 1976;
(4): 403-8.
Blair E, Stanley F. Aetiological pathways to spastic cerebral
palsy. Paediatr Perinat Epidemiol. 1993; 7(3): 302-317.
Coorssen EA, Msall ME, Duffy LC. Multiple minor
malformations as a marker for prenatal aetiology of cerebral
palsy. Dev Med Child Neurol. 1991; 33(8):730-6.
Miller G. Minor congenital anomalies and ataxic cerebral
palsy. Arch Dis Child. 1989; 64(4): 557-62.
Meyer BA, Dickinson JE, Chambers C, Parisi VM. The
effect of fetal sepsis on umbilical cord blood gases. Am J
Obstet Gynecol 1992; 166(2):612-7.
Nelson KB, Ellenberg JH. Obstetric complications as risk
factors for cerebral palsy or seizure disorders. JAMA 1984;
(14):1843-8.
Joreskog KG, Sorbom D. LISREL 7. A guide to the program
and applications. 2nd ed. Chicago: SPSS, 1989.
Ghorashi Z, Ahari HS, Okhchi RA. Birth injuries of neonates
in Alzahra hospital of Tabriz, Iran. Pak J Med Sci
;21(3):289-91.
Khreisa WH, Habahbeh Z. Risk factors of birth asphyxia: A
study at Prince Ali Ben Al Hussein hospital, Jordon. Pak J
Med Sci 2005. 21(1) 30-34.
Chishty AL, Iqbal MA, Anjum A, Maqbool S. Risk factor
analysis of birth asphyxia at the children’s hospital, Lahore.
Pak Paed J 2002; 26(2):47-53.
Afzal MF, Anjum A, Sultan MA. Risk factor analysis in
asphyxiated newborns and their outcome in relation to stage
of hypoxic ischemic encephalopathy. Pak Paed J 2007; 31(2):
-8.
Downloads
Issue
Section
License
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.