학술논문
RISK FACTORS OF PERINATAL ASPHYXIA AND NEONATAL OUTCOME
ORIGINAL ARTICLE
ORIGINAL ARTICLE
Document Type
Clinical report
Author
Source
Pediatric Oncall Journal. Oct-Dec 2021, Vol. 18 Issue 4, p107, 7 p.
Subject
Language
English
ISSN
0973-0966
Abstract
Introduction Perinatal asphyxia is defined by the World Health Organization (WHO) as the failure to initiate and sustain breathing at birth. (1) It is a common and serious neonatal problem [...]
Aim: To assess the incidence of perinatal asphyxia, its risk factors and outcome at a single tertiary referral center in Cameroon. Methods: This was a hospital-based prospective case-control study on term neonates delivered at tertiary referral center over three months. Cases were defined as neonates with an Apgar score less than 7 at the 5th minute. Controls were neonates with an Apgar score greater than or equal to 7 at the 5th minute, matched to cases for gestational age and sex. Maternal socio-demographic, antenatal, intrapartum, and neonatal variables including delivery outcome, Sarnat's score, time of death if it occurred, and duration of admission were noted. Risk factors for perinatal asphyxia were determined. Results: Of 740 live births during the study period, 72 (9.7%) neonates had perinatal asphyxia and most of the asphyxiated neonates were males (sex ratio 1.4), 86.1% weighed between 2500-3999g, and 42 (58.3%) mothers were in the age group between 18-29 years. Following multivariate analysis, risk factors for birth asphyxia included: were single mothers [AOR = 3.9993;95% CI: 1.1176-14.3110) p = 0.0331], mothers who had urinary tract infection in pregnancy [AOR = 15.6325;95% CI: 2.3083-105.8688) p = 0.0048], prolonged rupture of membranes [AOR = 6.2537;95% CI: 1.1744-33.3013) p = 0.0317], prolonged labor [AOR = 3.6521;95% CI: 1.0940-12.1918) p = 0.0352] and mothers who delivered by emergency caesarian section [OR = 8.0169;95% CI: 2.3669-27.1537), p = 0.0008]. Among the asphyxiated neonates, 15 died with a case fatality of 20.8%. Fourteen (93.3%) of those who died had severe asphyxia. Eighty-eight percent of asphyxiated neonates developed hypoxic ischemic encephalopathy, of which, 54.7% were Sarnat's stage I, 15.6% stage II and 29.7% stage III. Conclusion: The incidence and case fatality of perinatal asphyxia are high. Early diagnosis, prompt management of pathological disorders during pregnancy and labor, and neonatal resuscitation could largely prevent perinatal asphyxia. KEYWORDS Perinatal asphyxia, incidence, associated risk factors, Outcome
Aim: To assess the incidence of perinatal asphyxia, its risk factors and outcome at a single tertiary referral center in Cameroon. Methods: This was a hospital-based prospective case-control study on term neonates delivered at tertiary referral center over three months. Cases were defined as neonates with an Apgar score less than 7 at the 5th minute. Controls were neonates with an Apgar score greater than or equal to 7 at the 5th minute, matched to cases for gestational age and sex. Maternal socio-demographic, antenatal, intrapartum, and neonatal variables including delivery outcome, Sarnat's score, time of death if it occurred, and duration of admission were noted. Risk factors for perinatal asphyxia were determined. Results: Of 740 live births during the study period, 72 (9.7%) neonates had perinatal asphyxia and most of the asphyxiated neonates were males (sex ratio 1.4), 86.1% weighed between 2500-3999g, and 42 (58.3%) mothers were in the age group between 18-29 years. Following multivariate analysis, risk factors for birth asphyxia included: were single mothers [AOR = 3.9993;95% CI: 1.1176-14.3110) p = 0.0331], mothers who had urinary tract infection in pregnancy [AOR = 15.6325;95% CI: 2.3083-105.8688) p = 0.0048], prolonged rupture of membranes [AOR = 6.2537;95% CI: 1.1744-33.3013) p = 0.0317], prolonged labor [AOR = 3.6521;95% CI: 1.0940-12.1918) p = 0.0352] and mothers who delivered by emergency caesarian section [OR = 8.0169;95% CI: 2.3669-27.1537), p = 0.0008]. Among the asphyxiated neonates, 15 died with a case fatality of 20.8%. Fourteen (93.3%) of those who died had severe asphyxia. Eighty-eight percent of asphyxiated neonates developed hypoxic ischemic encephalopathy, of which, 54.7% were Sarnat's stage I, 15.6% stage II and 29.7% stage III. Conclusion: The incidence and case fatality of perinatal asphyxia are high. Early diagnosis, prompt management of pathological disorders during pregnancy and labor, and neonatal resuscitation could largely prevent perinatal asphyxia. KEYWORDS Perinatal asphyxia, incidence, associated risk factors, Outcome