RISK FACTORS OF BIRTH ASPHYXIA
AbstractBackground: 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)
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